Jonas T Johnson1, Barton F Branstetter. 1. Departments of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: Combined positron emission tomography with simultaneous computed tomography (PET/CT performed using 18F-fluorodeoxyglucose [FDG] as a radiopharmaceutical) results in improvement in anatomic localization of tumor. This review explores the contemporary application of PET/CT to pretreatment assessment, posttreatment monitoring, and subsequent treatment planning for patients with squamous carcinoma of the head and neck. DATA SOURCES: Contemporary publications on the use of PET/CT in head and neck oncology are reviewed and synthesized. REVIEW METHOD: This review presents selected literature interpreted by expert opinion. RESULTS: PET/CT is highly sensitive in staging of patients with squamous cancer of the head and neck. The sensitivity is limited by tumor size, and PET/CT cannot currently replace the information obtained from elective neck dissection in the assessment of cervical metastases. In the setting of posttreatment monitoring, PET/CT allows for identification of persistent carcinoma prior to clinical observation in approximately two-thirds of cases. However, contemporary reports do not allow assessment of cost effectiveness, and they do not allow determination if the application of PET/CT in this setting results in improved treatment outcomes. PET/CT is insensitive to evaluation of patients with glandular tumors, and those with low volume tumors and cystic metastases. CONCLUSIONS: PET/CT requires further evaluation before recommendations can be made regarding comparative effectiveness when compared to CT or MRI for posttreatment monitoring. The improved sensitivity and specificity of PET/CT during treatment planning justifies its use in this setting for patients with advanced stage squamous cancer of the head and neck.
OBJECTIVES/HYPOTHESIS: Combined positron emission tomography with simultaneous computed tomography (PET/CT performed using 18F-fluorodeoxyglucose [FDG] as a radiopharmaceutical) results in improvement in anatomic localization of tumor. This review explores the contemporary application of PET/CT to pretreatment assessment, posttreatment monitoring, and subsequent treatment planning for patients with squamous carcinoma of the head and neck. DATA SOURCES: Contemporary publications on the use of PET/CT in head and neck oncology are reviewed and synthesized. REVIEW METHOD: This review presents selected literature interpreted by expert opinion. RESULTS: PET/CT is highly sensitive in staging of patients with squamous cancer of the head and neck. The sensitivity is limited by tumor size, and PET/CT cannot currently replace the information obtained from elective neck dissection in the assessment of cervical metastases. In the setting of posttreatment monitoring, PET/CT allows for identification of persistent carcinoma prior to clinical observation in approximately two-thirds of cases. However, contemporary reports do not allow assessment of cost effectiveness, and they do not allow determination if the application of PET/CT in this setting results in improved treatment outcomes. PET/CT is insensitive to evaluation of patients with glandular tumors, and those with low volume tumors and cystic metastases. CONCLUSIONS: PET/CT requires further evaluation before recommendations can be made regarding comparative effectiveness when compared to CT or MRI for posttreatment monitoring. The improved sensitivity and specificity of PET/CT during treatment planning justifies its use in this setting for patients with advanced stage squamous cancer of the head and neck.
Authors: Jon Cacicedo; Iratxe Fernandez; Olga Del Hoyo; Ainara Dolado; Javier Gómez-Suarez; Eduardo Hortelano; Aintzane Sancho; Jose I Pijoan; Julio Alvarez; Jose M Espinosa; Ayman Gaafar; Pedro Bilbao Journal: Eur J Nucl Med Mol Imaging Date: 2015-05-08 Impact factor: 9.236
Authors: O A Catalano; E Nicolai; B R Rosen; A Luongo; M Catalano; C Iannace; A Guimaraes; M G Vangel; U Mahmood; A Soricelli; M Salvatore Journal: Br J Cancer Date: 2015-04-14 Impact factor: 7.640