FDG uptake in cervical lymph nodes in children without head and neck cancer

Vali, Reza; Bakkari, Alaa; Marie, Eman; Kousha, Mahnaz; Charron, Martin; Shammas, Amer

doi:10.1007/s00247-017-3835-8

Cited by 8 publications

(10 citation statements)

References 32 publications

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“…Recently, PARP1/2-targeted agents have received considerable attention as imaging agents (16,29) based on the ubiquitous and near-universal expression of PARP in many types of cancers, with the promise to serve as an accurate sensor of malignancy where standard of care methods currently fail. This is of particular interest for head and neck imaging, where clinicians face multiple diagnostic obstacles, including the difficulty to correctly determine the extent of primary tumors (3,4) and the presence of metastatic disease (5,6). PARP1 is highly expressed in oral and oropharyngeal squamous cell carcinoma, and the percentage of PARP1-positive tissue in a biopsy specimen correlates with disease grade (13).…”

Section: Discussionmentioning

confidence: 99%

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PARP1/2 imaging with ¹⁸F-PARPi in patients with head and neck cancer

Schöder

França

Nakajima

et al. 2019

Preprint

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Purpose. We performed a first-in-human clinical trial. The aim of this study was to determine safety and feasibility of PET imaging with 18F-PARPi in patients with head and neck cancer. Patients and Methods. Eleven patients (age 49 to 86 years) with newly diagnosed or recurrent oral and oropharyngeal cancer were injected intravenously with 18F-PARPi (331 ± 42 MBq) and dynamic PET/CT imaging was performed between 0 min and 25 min post-injection. Static PET/CT scans were obtained at 30 min, 60 min and 120 min p.i. Blood samples for tracer concentration and metabolite analysis were collected. Blood pressure, ECG, oxygen levels, clinical chemistry and CBC were obtained before and after administration of 18F-PARPi. Results. 18F-PARPi was well-tolerated by all patients without any safety concerns. Of the 11 patients included in the analysis, 18F-PARPi had focal uptake in all primary lesions (n = 10, SUVmax = 2.8 ± 1.2) and all 18F-FDG positive lymph nodes (n = 34). 18F-PARPi uptake was seen in 18F-FDG negative lymph nodes of three patients (n = 6). Focal uptake of tracer in primary and metastatic lesions was corroborated by CT alone or in combination with 18F-FDG. Contrast for 18F-PARPi and 18F-FDG was comparable (SUVmax(lesion)/SUVmax(genioglossus) = 3.3 and 3.0, respectively; p = 0.23), and SUVmax values for 18F-PARPi were less variable compared to 18F-FDG (1.3 versus 6.0, p = 0.001). Conclusions. Imaging of head and neck cancer with 18F-PARPi is feasible and safe. 18F-PARPi detects primary and metastatic lesions, and retention in tumors is longer than in healthy tissues.

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Section: Discussionmentioning

confidence: 99%

“…Many patients present with enlarged lymph nodes due to inflammation around the tumor site. These inflamed lymph nodes may mimic neck metastases on CT scans and are often 18 F-FDG PET avid (5)(6)(7)(8). On the other hand, some metastatic neck nodes may not be enlarged and show no abnormal 18 F-FDG uptake.…”

Section: Introductionmentioning

confidence: 99%

PARP1/2 imaging with ¹⁸F-PARPi in patients with head and neck cancer

Schöder

França

Nakajima

et al. 2019

Preprint

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“…Detection of micrometastatic nodal disease, or confirmation of clinically suspicious or imaging‐equivocal LN disease in the head and neck, poses unique challenges. Foremost, cross‐sectional imaging and FDG‐PET have a limited positive predictive value (29%) for the detection of sarcoma LN metastases, and benign reactive lymphadenopathy commonly clouds radiologic interpretation . Furthermore, head and neck lymphatic drainage is often variable and difficult to predict despite the location of the primary tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Foremost, cross-sectional imaging and FDG-PET have a limited positive predictive value (29%) for the detection of sarcoma LN metastases, 5 and benign reactive lymphadenopathy commonly clouds radiologic interpretation. 18 Furthermore, head and neck lymphatic drainage is often variable and difficult to predict despite the location of the primary tumor. In this series, SLNs were identified contralateral to the primary tumor in two patients, one of which was positive for metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in head and neck rhabdomyosarcoma

Turpin

Pressey

Nagarajan

et al. 2018

Pediatric Blood & Cancer

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Head and neck rhabdomyosarcoma lymph node staging is challenging due to varied patterns of lymphatic drainage and the suboptimal predictive value of available imaging modalities. Furthermore, regional relapse rates are unacceptably high, and the toxicity of empiric radiation is undesirable in the pediatric and young adult population. In an attempt to improve locoregional control without excess morbidity, we have adopted routine sentinel lymph node biopsy in head and neck rhabdomyosarcoma, which is safe and feasible in pediatric patients. Of six procedures reported here, pathologic findings led to intensification of regional and/or systemic therapy in two patients.

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“…However, uptake in the Waldeyer's ring is commonly reported in children and not necessarily indicative of pathology, leading to potential misinterpretation of uptake in this area as physiological (29). Additionally, although reactive 18 F-FDG-avid lymph nodes in the cervical region are also often reported in children, cervical malignant lymphadenopathy seems to occur more frequently in PTLD than in immunocompetent lymphoma patients (30). The gastrointestinal tract is also a commonly reported PTLD location in pediatric patients (7,31).…”

Section: F-fdg Pet/ct For Response Assessmentmentioning

confidence: 99%