FDG-PET/CT improves detection of residual disease and reduces the need for examination under anaesthesia in oropharyngeal cancer patients treated with (chemo-)radiation

Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition

“…[791][792][793] Equivocal FDG PET-CT findings in patients with HPV-negative oropharyngeal SCC are associated with a high specificity for residual disease and will need surgical treatment. 794, 795 Posttreatment neck dissection should include at least the nodal level(s) demonstrated on the FDG PET-CT and an adjacent level if possible. Evidence for the extent of neck dissection is absent.…”

Follow-Up and Management of Patients With Head and Neck Cancer During the 2019 Novel Coronavirus (SARS-CoV-2) Disease Pandemic

“…For patients treated with definitive radiation therapy or chemoradiation therapy or those undergoing reirradiation, this is a typical time frame for posttreatment imaging studies to evaluate the adequacy of tumor response to treatment and determine whether posttreatment neck dissection or surgical salvage is required. 17,18 Given the importance of the data obtained at this time point, it is our opinion that effort should be made to complete posttreatment imaging that has the potential to influence treatment decision-making. Any delay in imaging beyond standard 12-week posttreatment timing should be limited.…”

COVID-19—An Opportunity for Optimizing Surveillance Protocols During and Beyond the Pandemic: HPV-Associated Oropharyngeal Cancer as an Example of Response-Based Local Surveillance

“…In those with an equivocal scan, a “second-look” PET/CT can be invaluable, with many patients subsequently converting to a CMR, obviating the need for an unnecessary neck dissection or examination under anesthesia. 3 , 4 , 5 With the increasing incidence of HPV-OPC, a substantial proportion of the posttreatment FDG-PET/CT literature has either focused on or included significant proportions of patients with this disease. In HPV-OPC, where the neck response can lag behind that of the primary site and the predominant pattern of recurrence is distant or regional failure, 5 , 6 , 7 , 8 it is not surprising that much of the published research on FDG-PET/CT has focused on the assessment of the neck.…”