FDG-PET/CT imaging for staging and radiotherapy treatment planning of head and neck carcinoma

“…On the other hand, it was difficult to identify musculature, major vessels including the carotid artery and jugular vein, and maxillary sinuses, which were readily delineated in the same subjects with the use of CT and MRI. The utility of FDG-PET/CT for diagnosing head and neck cancers has been reported, and it was found that the method shows both anatomical and functional images simultaneously (15,16). Additional investigations of PET/CT with fluoridelabeled BPA as a tracer are warranted, not only for improving the diagnostic potential, but also for treatment planning.…”

Section: Discussionmentioning

confidence: 99%

Fluorine-18-labeled boronophenylalanine positron emission tomography for oral cancers: Qualitative and quantitative analyses of malignant tumors and normal structures in oral and maxillofacial regions

et al. 2011

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Abstract. The present study aimed to demonstrate the features of fluorine-18-labeled boronophenylalanine positron emission tomography ( 18 F-BPA-PET) to reveal oral cancer, as well as normal structures in the oral and maxillofacial regions. We analyzed 18 F-BPA-PET findings from 8 patients with histologically confirmed recurrent and/or advanced oral cancer scheduled for boron neutron capture therapy. The capacity of 18 F-BPA-PET to delineate tumor and normal structures was assessed qualitatively and quantitatively. Tumors were easily identified as high uptake areas in all cases. Although the eyes, which were depicted as a low uptake area, and tongue musculature were readily identified, major vessels were not noted in any of the cases. Areas corresponding to the surface of the dorsum tongue to middle pharynx were expressed as high uptake areas in all of the cases. Quantitatively, tumors were expressed as the highest uptake area in 6 of the 8 cases, while the dorsum tongue had the highest uptake area in the remaining 2 cases.18 F-BPA-PET is useful in demonstrating the presence of a tumor. Thus, it is crucial to note the presence of a high uptake area corresponding to the dorsum area of the tongue when diagnosing a tumor using this technique. IntroductionFluorodeoxyglucose (FDG) positron emission tomography (PET) has recently become widely used for detecting malignant tumors of the oral cavity, particularly for the diagnosis of metastatic deposits (1). In addition, another type of PET method, methionine-basis PET, has been shown to be useful for diagnosing malignancies (2).Boron neutron capture therapy (BNCT) was recently performed in order to regulate non-resectable advanced and/or recurrent oral cancers, and its clinical utility was previously reported (3,4). However, certain patients suffer from alopecia and/or mucositis after undergoing BNCT (3,5). For planning, as well as predicting the outcome and adverse effects of this therapy, boron concentrations should be evaluated in surrounding normal structures as well as in the tumor itself, for which fluorine-18-labeled boronophenylalanine ( 18 F-BPA) PET was utilized. To the best of our knowledge, features of normal tissues and tumors in 18 F-BPA-PET images have yet to be adequately assessed. The present study therefore aimed to qualitatively and quantitatively elucidate the features of normal structures in the oral and maxillofacial regions, as well as associated tumors revealed by 18 F-BPA-PET imaging. Materials and methodsThe study evaluated 18 F-BPA-PET images obtained in examinations of 8 patients with histologically confirmed recurrent and/or advanced oral cancer, or metastatic lymphadenopathy who were scheduled for BNCT (Table I). Seven of the patients were treated with a combination of surgery, chemotherapy and radiotherapy, while 1 patient was treated with thermotherapy. All PET examinations were performed using an ECAT ACCEL (Siemens Japan Co., Tokyo, Japan) with 18 F-labeled BPA (37-55.5 MBq/10 kg of body weight) injected 45 min prior to obtaining the im...

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“…They compared results of conventional diagnostic methods and PET/CT and reported a change in TNM classification in 5 cases. Overall gross tumor volume was higher by 6 cm 3 based on PET/CT, in comparison with CT based GTV [12].…”

Section: Discussionmentioning

confidence: 97%

“…Data from the literature suggests that treatment planning based on PET-CT may considerably differ from the planning based solely on CT imaging [11,12]. Estimated 30% to 40% of radiation plans were modified due to the use of PET examinations in the planning process.…”

mentioning

confidence: 99%

PET/CT significance for planning radiotherapy of head and neck cancer

Kolářová¹,

Vaňásek²,

Kandrnal³

et al. 2012

neo

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The combination of positron emission tomography and computed tomography (PET/CT) offers metabolic mapping in addition to anatomic information of the primary lesion, nodal and distant metastases in patients with head and neck tumors, and may be therefore beneficial for radiotherapy planning. The aim of our study was to evaluate benefits of combined PET and CT imaging for staging and target volume delineation in this group of patients.Fifty three patients (40 men and 13 women) with confirmed advanced, inoperable or non-radically operated head and neck cancer were assessed based on the results of PET/CT as well as standard diagnostic examinations. All patients were subsequently treated with intensity modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) of 6 MV X-rays.There was an agreement between the standard examinations results and results of PET/CT in 30 cases. In 23 cases there was disagreement either in tumor size, nodal involvement or presence of distant metastases. Results of the tumor size assessment differed significantly in 5 cases. There was no agreement found in nodal involvement in 10 cases. The cancer confirmed by standard examination was not found by PET/CT in 2 cases; 3 PET/CT positive findings were not confirmed by standard examinations. In 3 patients PET-CT revealed new distant metastatic disease. Based on PET/CT assessment we changed treatment strategy and applied potentially curative dose of radiotherapy to previously undiscovered regions in 9 patients. We decided to change the treatment intent in 3 cases and only palliative treatment was applied. Based on our experience and the literature review, PET/CT may be considerable contribution to the standard diagnostic procedures in approximately one third of cases.

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FDG-PET/CT imaging for staging and radiotherapy treatment planning of head and neck carcinoma

Abstract: PET/CT fusion images could have a potential impact on both tumor staging and treatment planning.

Cited by 81 publications

References 25 publications

Role of PET/CT in Treatment Planning for Head and Neck Cancer Patients Undergoing Definitive Radiotherapy

Role of PET/CT in Treatment Planning for Head and Neck Cancer Patients Undergoing Definitive Radiotherapy

Fluorine-18-labeled boronophenylalanine positron emission tomography for oral cancers: Qualitative and quantitative analyses of malignant tumors and normal structures in oral and maxillofacial regions

PET/CT significance for planning radiotherapy of head and neck cancer

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