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FDG-PET/CT in cancers of the head and neck: what is the definition of whole body scanning?
- Source :
- Molecular imaging and biology. 13(2)
- Publication Year :
- 2010
-
Abstract
- The role of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) was studied in a variety of cancers, including head and neck squamous cell carcinomas (HNSCC) and nasopharyngeal carcinomas (NPC), with several presentations indicating that for these clinical entities a “whole-body” (i.e., eyes to thighs) may yield little additional information. Therefore, we were prompted to review our experience with PET/computed tomography (CT) in the management of patients with HNSCC and NPC. This is a retrospective study of 133 patients with HNSCC, 23-90 years old (average: 58.2 ± 12.7) and 26 patients with NPC, ages 16-75 (average: 47.3 ± 17.1), who had whole body PET/CT at our institution from Jan 2003 to Nov 2006. Reinterpretation of the imaging studies for accuracy and data analysis from medical records was performed. Lesions identified on PET/CT below the level of the adrenal glands were recorded and tabulated. Lesions were identified below the adrenal glands in seven patients (5.2%) with HNSCC. These included hepatic and osseous metastases from HNSCC in two patients (1.5%), a new renal cancer (0.75%), a new pancreatic cancer (0.75%), a new colon cancer (0.75%) and findings proven benign on follow-up (focal colon uptake in one patient and an inflammatory inguinal lymph node in another patient; 1.5%). Lesions were identified below the adrenal glands in three patients (11.5%) with NPC. These included osseous metastases from NPC in two patients (7.7%) and findings proven benign on follow-up (focal colon uptake in one patient; 3.84%). This study suggests that whole body PET/CT imaging in HNSCC has a relatively low yield (3%, 95% CI: 1.33-8.42) of significant findings below the level of the adrenal glands. Therefore, implementing a more limited protocol (through the level of adrenal glands), especially in low-risk cases of HNSCC, may be considered. However, whole body PET/CT imaging in NPC may have a significant yield (7.7%, 95% CI: 1.02-25.26) of medically relevant findings below the level of the adrenal glands. Thus, the whole body (i.e., vertex to thighs) PET/CT scan of NPC patients appears to be the appropriate imaging protocol for this population. This recommendation requires further evaluation and validation in larger prospective studies.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Adolescent
Colorectal cancer
Population
Young Adult
Fluorodeoxyglucose F18
Pancreatic cancer
otorhinolaryngologic diseases
medicine
Carcinoma
Humans
Radiology, Nuclear Medicine and imaging
Whole Body Imaging
education
Prospective cohort study
Aged
Aged, 80 and over
education.field_of_study
medicine.diagnostic_test
business.industry
Cancer
Retrospective cohort study
Middle Aged
medicine.disease
stomatognathic diseases
Oncology
Positron emission tomography
Head and Neck Neoplasms
Positron-Emission Tomography
Carcinoma, Squamous Cell
Female
Radiology
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 18602002
- Volume :
- 13
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Molecular imaging and biology
- Accession number :
- edsair.doi.dedup.....b8b587d71f6876f57f753599858ea267