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FDG PET Imaging of Head and Neck Cancers

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Part of the book series: Methods in Molecular Biology ((MIMB,volume 727))

Abstract

In initial staging of head and neck cancers, the addition of FDG PET to conventional imaging improves the accuracy for cervical nodal metastases. The sensitivity of FDG PET is, however, limited in nodes <1 cm and in completely necrotic nodes. In the posttherapy setting, PET scans obtained at least 10 weeks after radiotherapy have an excellent predictive value to rule out residual disease. Due to the limited positive predictive value of FDG PET after radiation therapy, a positive PET scan needs to be confirmed before management decisions are made.

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References

  1. Jemal, A., Siegel, R., Ward, E., et al. (2008) Cancer statistics, 2008. CA Cancer J Clin 58, 71–96.

    Article  PubMed  Google Scholar 

  2. Lindholm, P., Minn, H., Leskinen-Kallio, S., Bergman, J., Ruotsalainen, U., Joensuu, H. (1993) Influence of the blood glucose concentration on FDG uptake in cancer  –  a PET study. J Nucl Med 34, 1–6.

    PubMed  CAS  Google Scholar 

  3. Yeung, H.W., Grewal, R.K., Gonen, M., Schoder, H., Larson, S.M. (2003) Patterns of (18)F-FDG uptake in adipose tissue and muscle: a potential source of false-positives for PET. J Nucl Med 44, 1789–96.

    PubMed  Google Scholar 

  4. Garcia, C.A., Van Nostrand, D., Atkins, F., et al. (2006) Reduction of brown fat 2-deoxy-2-[F-18]fluoro-D-glucose uptake by controlling environmental temperature prior to positron emission tomography scan. Mol Imaging Biol 8, 24–9.

    Article  PubMed  Google Scholar 

  5. Brink, I., Klenzner, T., Krause, T., et al. (2002) Lymph node staging in extracranial head and neck cancer with FDG PET – appropriate uptake period and size-dependence of the results. Nuklearmedizin 41, 108–13.

    PubMed  CAS  Google Scholar 

  6. Graham, M.M., Menda, Y. (2005) Positron emission tomography/computed tomography imaging of head and neck tumors: an atlas. Semin Nucl Med 35, 220–52.

    Article  PubMed  Google Scholar 

  7. Greene F., Fleming, I.D. (2002) AJCC (American Joint Committee on Cancer) Cancer Staging Manual 6th edn, Springer-Verlag, New York.

    Google Scholar 

  8. Robbins, K.T., Clayman, G., Levine, P.A., et al. (2002) Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 128, 751–8.

    PubMed  Google Scholar 

  9. Di Martino, E., Nowak, B., Krombach, G.A., et al. (2000) Results of pretherapeutic lymph node diagnosis in head and neck tumors. Clinical value of 18-FDG positron emission tomography (PET). Laryngorhinootologie 79, 201–6.

    Article  PubMed  Google Scholar 

  10. Hannah, A., Scott, A.M., Tochon-Danguy, H., et al. (2002) Evaluation of 18 F- fluorodeoxyglucose positron emission tomography and computed tomography with histopathologic correlation in the initial staging of head and neck cancer. Ann Surg 236, 208–17.

    Article  PubMed  Google Scholar 

  11. Kresnik, E., Mikosch, P., Gallowitsch, H.J., et al. (2001) Evaluation of head and neck cancer with 18 F-FDG PET: a comparison with conventional methods. Eur J Nucl Med 28, 816–21.

    Article  PubMed  CAS  Google Scholar 

  12. Stuckensen, T., Kovacs, A.F., Adams, S., Baum, R.P. (2000) Staging of the neck in patients with oral cavity squamous cell carcinomas: a prospective comparison of PET, ultrasound, CT and MRI. J Craniomaxillofac Surg 28, 319–24.

    Article  PubMed  CAS  Google Scholar 

  13. Civantos, F.J., Gomez, C., Duque, C., et al. (2003) Sentinel node biopsy in oral cavity cancer: correlation with PET scan and immunohistochemistry. Head Neck 25, 1–9.

    Article  PubMed  Google Scholar 

  14. Hyde, N.C., Prvulovich, E., Newman, L., Waddington, W.A., Visvikis, D., Ell, P. (2003) A new approach to pre-treatment assessment of the N0 neck in oral squamous cell carcinoma: the role of sentinel node biopsy and positron emission tomography. Oral Oncol 39, 350–60.

    Article  PubMed  CAS  Google Scholar 

  15. Stoeckli, S.J., Steinert, H., Pfaltz, M., Schmid, S. (2002) Is there a role for positron mission tomography with 18 F-fluorodeoxyglucose in the initial staging of nodal negative oral and oropharyngeal squamous cell carcinoma. Head Neck 24, 345–9.

    Article  PubMed  Google Scholar 

  16. Schoder, H., Carlson, D.L., Kraus, D.H., et al. (2006) 18 F-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI. J Nucl Med 47, 755–62.

    PubMed  Google Scholar 

  17. Kim, S.Y., Roh, J.L., Yeo, N.K., et al. (2007) Combined 18 F-fluorodeoxyglucose-positron emission tomography and computed tomography as a primary screening method for detecting second primary cancers and distant metastases in patients with head and neck cancer. Ann Oncol 18, 1698–703.

    Article  PubMed  CAS  Google Scholar 

  18. Goerres, G.W., Schmid, D.T., Gratz, K.W., von Schulthess, G.K., Eyrich, G.K. (2003) Impact of whole body positron emission tomography on initial staging and therapy in patients with squamous cell carcinoma of the oral cavity. Oral Oncol 39, 547–51.

    Article  PubMed  CAS  Google Scholar 

  19. Schwartz, D.L., Rajendran, J., Yueh, B., et al. (2003) Staging of head and neck squamous cell cancer with extended-field FDG-PET. Arch Otolaryngol Head Neck Surg 129, 1173–8.

    Article  PubMed  Google Scholar 

  20. Sigg, M.B., Steinert, H., Gratz, K., Hugenin, P., Stoeckli, S., Eyrich, G.K., et al. (2003) Staging of head and neck tumors: [18 F]fluorodeoxyglucose positron emission tomography compared with physical examination and conventional imaging modalities. J Oral Maxillofac Surg 61, 1022–9.

    Article  PubMed  Google Scholar 

  21. Teknos, T.N., Rosenthal, E.L., Lee, D., Taylor, R., Marn, C.S. (2001) Positron emission tomography in the evaluation of stage III and IV head and neck cancer Head Neck 23, 1056–60.

    Article  PubMed  CAS  Google Scholar 

  22. Mendenhall, W.M., Mancuso, A.A., Parsons, J.T., Stringer, S.P., Cassisi, N.J. (1998) Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site. Head Neck 20, 739–44.

    Article  PubMed  CAS  Google Scholar 

  23. Mendenhall, W.M., Mancuso, A.A., Amdur, R.J., Stringer, S.P., Villaret, D.B., Cassisi, N.J. (2001) Squamous cell carcinoma metastatic to the neck from an unknown head and neck primary site. Am J Otolaryngol 22, 261–7.

    Article  PubMed  CAS  Google Scholar 

  24. Rusthoven, K.E., Koshy, M., Paulino, A.C. (2004) The role of fluorodeoxyglucose positron emission tomography in cervical lymph node metastases from an unknown primary tumor. Cancer 101, 2641–9.

    Article  PubMed  Google Scholar 

  25. Fogarty, G.B., Peters, L.J., Stewart, J., Scott, C., Rischin, D., Hicks, R.J. (2003) The usefulness of fluorine 18-labelled deoxyglucose positron emission tomography in the investigation of patients with cervical lymphadenopathy from an unknown primary tumor. Head Neck 25, 138–45.

    Article  PubMed  Google Scholar 

  26. Greven, K.M., Keyes, J.W., Jr., Williams, D.W., III, McGuirt, W.F., Joyce, W.T., III. (1999) Occult primary tumors of the head and neck: lack of benefit from positron emission tomography imaging with 2-[F-18]fluoro-2-deoxy-D-glucose. Cancer 86, 114–8.

    Article  PubMed  CAS  Google Scholar 

  27. Johansen, J., Eigtved, A., Buchwald, C., Theilgaard, S.A., Hansen, H.S. (2002) Implication of 18 F-fluoro-2-deoxy-D-glucose positron emission tomography on management of carcinoma of unknown primary in the head and neck: a Danish cohort study. Laryngoscope 112, 2009–14.

    Article  PubMed  Google Scholar 

  28. Jungehulsing, M., Scheidhauer, K., Damm, M., et al. (2000) 2[F]-fluoro-2-deoxy-D-glucose positron emission tomography is a sensitive tool for the detection of occult primary cancer (carcinoma of unknown primary syndrome) with head and neck lymph node manifestation. Otolaryngol Head Neck Surg 123, 294–301.

    Article  PubMed  CAS  Google Scholar 

  29. Kole, A.C., Nieweg, O.E., Pruim, J., et al. (1998) Detection of unknown occult primary tumors using positron emission tomography. Cancer 82, 1160–6.

    Article  PubMed  CAS  Google Scholar 

  30. Wong, W.L., Saunders, M. (2003) The impact of FDG PET on the management of occult primary head and neck tumours. Clin Oncol (R Coll Radiol) 15, 461–6.

    Article  CAS  Google Scholar 

  31. Goodwin, W.J., Jr. (2000) Salvage surgery for patients with recurrent squamous cell carcinoma of the upper aerodigestive tract: when do the ends justify the means. Laryngoscope 110, 1–18.

    Article  PubMed  Google Scholar 

  32. Klabbers, B.M., Lammertsma, A.A., Slotman, B.J. (2003) The value of positron emission tomography for monitoring response to radiotherapy in head and neck cancer. Mol Imaging Biol 5, 257–70.

    Article  PubMed  Google Scholar 

  33. Isles, M.G., McConkey, C., Mehanna, H.M. (2008) A systematic review and meta-analysis of the role of positron emission tomography in the follow up of head and neck squamous cell carcinoma following radiotherapy or chemoradiotherapy. Clin Otolaryngol 33, 210–22.

    Article  PubMed  CAS  Google Scholar 

  34. Yao, M., Smith, R.B., Hoffman, H.T., et al. (2009) Clinical significance of postradiotherapy [18 F]-fluorodeoxyglucose positron emission tomography imaging in management of head-and-neck cancer – a long-term outcome report. Int J Radiat Oncol Biol Phys 74, 9–14.

    Article  PubMed  CAS  Google Scholar 

  35. Greven, K.M., Williams, D.W., III, McGuirt, W.F., Sr., et al. (2001) Serial positron emission tomography scans following radiation therapy of patients with head and neck cancer. Head Neck 23, 942–6.

    Article  PubMed  CAS  Google Scholar 

  36. Yao, M., Smith, R.B., Graham, M.M., et al. (2005) The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment. Int J Radiat Oncol Biol Phys 63, 991–9.

    Article  PubMed  Google Scholar 

  37. Porceddu, S.V., Jarmolowski, E., Hicks, R.J., et al. (2005) Utility of positron emission tomography for the detection of disease in residual neck nodes after (chemo)radiotherapy in head and neck cancer. Head Neck 27, 175–81.

    Article  PubMed  Google Scholar 

  38. Kutler, D.I., Patel, S.G., Shah, J.P. (2004) The role of neck dissection following definitive chemoradiation. Oncology (Williston Park) 18, 993–8; discussion 999, 1003–4, 1007.

    Google Scholar 

  39. Rogers, J.W., Greven, K.M., McGuirt, W.F., et al. (2004) Can post-RT neck dissection be omitted for patients with head-and-neck cancer who have a negative PET scan after definitive radiation therapy. Int J Radiat Oncol Biol Phys 58, 694–7.

    Article  PubMed  Google Scholar 

  40. Schoder, H., Yeung, H.W. (2004) Positron emission imaging of head and neck cancer, including thyroid carcinoma. Semin Nucl Med 34, 180–97.

    Article  PubMed  Google Scholar 

  41. Terhaard, C.H., Bongers, V., van Rijk, P.P., Hordijk, G.J. (2001) F-18-fluoro-deoxy-glucose positron-emission tomography ­scanning in detection of local recurrence after radiotherapy for laryngeal/pharyngeal cancer. Head Neck 23, 933–41.

    Article  PubMed  CAS  Google Scholar 

  42. Allal, A.S., Slosman, D.O., Kebdani, T., Allaoua, M., Lehmann, W., Dulguerov, P. (2004) Prediction of outcome in head-and-neck cancer patients using the standardized uptake value of 2-[18 F]fluoro-2-deoxy-D-glucose. Int J Radiat Oncol Biol Phys 59, 1295–300.

    Article  PubMed  CAS  Google Scholar 

  43. Ciernik, I.F., Dizendorf, E., Baumert, B.G., et al. (2003) Radiation treatment planning with an integrated positron emission and computer tomography (PET/CT): a feasibility study. Int J Radiat Oncol Biol Phys 57, 853–63.

    Article  PubMed  Google Scholar 

  44. Paulino, A.C., Koshy, M., Howell, R., Schuster, D., Davis, L.W. (2005) Comparison of CT- and FDG-PET-defined gross tumor volume in intensity-modulated radiotherapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys 61, 1385–92.

    Article  PubMed  Google Scholar 

  45. Heron, D.E., Andrade, R.S., Flickinger, J., et al. (2004) Hybrid PET-CT simulation for radiation treatment planning in head-and-neck cancers: a brief technical report. Int J Radiat Oncol Biol Phys 60, 1419–24.

    Article  PubMed  Google Scholar 

  46. Dietl, B., Marienhagen, J., Kuhnel, T., Schreyer, A., Kolbl, O. (2008) The impact of FDG-PET/CT on the management of head and neck tumours: the radiotherapist’s perspective. Oral Oncol 44, 504–8.

    Article  PubMed  CAS  Google Scholar 

  47. Paulino, A.C., Johnstone, P.A. (2004) FDG-PET in radiotherapy treatment planning: Pandora’s box. Int J Radiat Oncol Biol Phys 59, 4–5.

    Article  PubMed  Google Scholar 

  48. Scarfone, C., Lavely, W.C., Cmelak, A.J., et al. (2004) Prospective feasibility trial of radiotherapy target definition for head and neck cancer using 3-dimensional PET and CT imaging. J Nucl Med 45, 543–52.

    PubMed  Google Scholar 

  49. Wang, D., Schultz, C.J., Jursinic, P.A., et al. (2006) Initial experience of FDG-PET/CT guided IMRT of head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 65, 143–51.

    Article  PubMed  Google Scholar 

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Correspondence to Yusuf Menda .

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© 2011 Humana Press

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Menda, Y., Graham, M.M. (2011). FDG PET Imaging of Head and Neck Cancers. In: Juweid, M., Hoekstra, O. (eds) Positron Emission Tomography. Methods in Molecular Biology, vol 727. Humana Press. https://doi.org/10.1007/978-1-61779-062-1_2

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  • DOI: https://doi.org/10.1007/978-1-61779-062-1_2

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