Radiographic Response Assessments and Standardized Imaging Interpretation Criteria in Head and Neck Cancer on FDG PET/CT: A Narrative Review.

Simple Summary: Despite multiple standardized interpretation criteria (SICs) for imaging response assessment in patients with head and neck squamous cell carcinoma (HNSCC), these systems remain relatively underutilized. This underutilization may in part relate to the fact that the relevant information has been published in disparate journals over multiple decades. This paper aims to review the SICs available for use in interpreting post-treatment FDG PET/CT in patients with HNSCC. We evaluate each SIC in the context of eight desired traits. Selecting a SIC that best matches the needs of one's practice is expected to facilitate multidisciplinary buy-in and maximize the likelihood of successful implementation. Introduction: There is growing interest in the development and application of standardized imaging criteria (SIC), to minimize variability and improve the reproducibility of image interpretation in head and neck squamous cell carcinoma (HNSCC). Methods: "Squamous cell carcinoma" AND "standardized interpretation criteria" OR "radiographic response assessment" were searched using PubMed and Google Scholar for articles published between 2009 and 2024, returning 56 publications. After abstract review, 18 were selected for further evaluation, and 6 different SICs (i.e., PERCIST, Porceddu, Hopkins, NI-RADS, modified Deauville, and Cuneo) were included in this review. Each SIC is evaluated in the context of 8 desired traits of a standardized reporting system. Results: Two SICs have societal endorsements (i.e., PERCIST, NI-RADS); four can be used in the evaluation of locoregional and systemic disease (i.e., PERCIST, Hopkins, NI-RADS, Cuneo), and four have specific categories for equivocal imaging results (i.e., Porceddu, NI-RADS, modified Deauville, and Cuneo). All demonstrated areas for future improvement in the context of the 8 desired traits. Conclusion: Multiple SICs have been developed for and demonstrated value in HNSCC post-treatment imaging; however, these systems remain underutilized. Selecting an SIC with features that best match the needs of one's practice is expected to maximize the likelihood of successful implementation. [ABSTRACT FROM AUTHOR]