Incidental findings on 18-FDG PET–CT in head and neck cancer. A retrospective case-control study of incidental findings on 18-FDG PET–CT in patients with head and neck cancer

Casselden, Elizabeth; Sheerin, Fintan; Winter, Stuart C

doi:10.1007/s00405-018-5203-1

Cited by 9 publications

(8 citation statements)

References 8 publications

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“…Wang et al investigated FDG‐PET/CT restaging examinations for different cancers and reported an overall rate of 8% proven synchronous second primaries 43 . For head and neck cancer, Britt et al and Casselden et al found synchronous second primaries in 3.2% (3/93) and 4.1% (12/293), respectively 44,45 . In our study, a second primary was found in 6.1% (6/96) of all PET examinations.…”

Section: Discussionsupporting

confidence: 57%

Whole‐body hybrid positron emission tomography imaging yields clinically relevant information in the staging and restaging of sinonasal tumors

et al. 2021

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Background Whole‐body hybrid positron emission tomography (PET) imaging is increasingly used for sinonasal tumors. However, only empirical data exist on the additional, clinically relevant information derived from these techniques. Methods This study included 96 regionalized magnetic resonance imaging (MRI) of the sinonasal tract/neck and separate hybrid FDG‐PET/CT or FDG‐PET/MRI in 74 patients. Additional radiological information (ARI) obtained from each hybrid examination was analyzed and its clinically relevance was determined. Clinically relevant information (CRI) was categorized with regard to primary tumor site, regional lymph node metastases, distant metastases, second primary tumors, and non‐neoplastic findings. Results A total of 45/96 (46.9%) hybrid PET examinations revealed ARI. CRI was found in 32/96 (33.3%) examinations and concerned the primary tumor site (6.1%), regional lymph node metastases (4.1%), distant metastases (14.3%), second primary tumors (7.3%), and non‐neoplastic findings (5.1%). Conclusions Hybrid PET imaging yields additional radiological information translating into clinically relevant information in a substantial proportion of patients with sinonasal tumors.

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Section: Discussionsupporting

confidence: 57%

Whole‐body hybrid positron emission tomography imaging yields clinically relevant information in the staging and restaging of sinonasal tumors

et al. 2021

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“…The field of view in the oral and maxillofacial region often includes a region from the base of the brain to the apex of the lung, and thus oral radiologists need to take care to observe adjacent regions in the images. Indeed, many incidental findings have been described in previous reports (6)(7)(8)(9)(19)(20)(21). The thyroid gland should be focused upon because its entirety is frequently included in CT images of the oral and maxillofacial region.…”

Section: Discussionmentioning

confidence: 97%

“…With the development of imaging modalities in recent years, there has been an increase in the identification of incidental lesions on images obtained by CT and MRI, as advanced imaging modalities (6)(7)(8)(9)(19)(20)(21). In particular, CT machines are maintained at many facilities, and it is possible to obtain more detailed diagnoses by CT immediately after lesions are suspected on plain radiographs of the oral and maxillofacial region.…”

Section: Discussionmentioning

confidence: 99%

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Incidental findings in the thyroid gland on computed tomography images of the oral and maxillofacial region

et al. 2020

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The numbers of abnormal findings incidentally detected in adjacent regions are increasing with advances in imaging modalities. The present study aimed to examine the prevalence and characteristics of incidental findings in the thyroid gland on computed tomography (CT) images of the oral and maxillofacial region. CT scans of the oral and maxillofacial region in patients obtained between January 2012 and December 2016 were retrospectively reviewed. Images that revealed incidental findings in the thyroid gland, including nodules, were recorded, together with the sizes and characteristics of the findings. The Japan Association of Breast and Thyroid Sonology (JABTS) guidelines were used for classification. The rate of descriptions of these findings in the radiographic interpretation reports were also examined. Of the 1,135 patients examined, 326 (28.7%) had several types of incidental findings. In particular, 169 (14.9%) of the 1,135 patients had nodules >5 mm in diameter, for which further careful examination is recommended in the JABTS guideline. The description rate for nodules >5 mm in diameter in the radiographic interpretation reports was 30.8% (52/169 patients), of whom 17.3% (9/52 patients) were referred to the endocrinology department for further careful examination. Incidental findings in the thyroid gland were relatively common on CT images of the oral and maxillofacial region. Oral radiologists tend to focus specifically on the oral and maxillofacial region during diagnosis on oral and maxillofacial CT images, but should pay the same careful attention to observe adjacent regions, such as the thyroid gland.

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“…However, to the best of our knowledge, no studies have investigated incidental FDG uptake in the oropharynx specifically. Incidental PET uptake in the head and neck was analysed in 16 papers and was shown to occur in 13.8% of scans on average (Table 4) [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. The presence of PET incidentalomas was associated with a significant increase in time to commencement of treatment [14].…”

Section: Discussionmentioning

confidence: 99%

Incidental uptake of fluorodeoxyglucose in the Waldeyer’s ring and risk of oropharyngeal malignancy

Bujoreanu

Gujral

Wallitt

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Fluorodeoxyglucose (FDG) positron emission tomography (PET) is increasingly used to diagnose and stage malignancy. The aim of this article is to investigate the significance of incidental FDG uptake in the Waldeyer’s ring and to assess its value in predicting clinically occult oropharyngeal malignancy. Methods All FDG-PET/CT scans performed in Imperial College NHS Foundation Trust, UK between January 2012 and November 2018 were included. Patients with known or suspected oropharyngeal malignancy or lymphoma were excluded. Minimum follow-up was 12 months. Results A total of 724 scans revealed oropharyngeal uptake of FDG. Of these, 102 were included in the study. Most patients (62.1%) were scanned as part of staging for other malignancies. Oropharyngeal FDG uptake was asymmetrical in 57.3% of the cases. Uptake was more common in the tonsils (56.3%), followed by the tongue base (31.1%) and both sites (12.6%). In 41.7% of reports, appearance was described as likely physiological; however, 52.4% of reports advised direct visualisation, clinical correlation or ENT opinion. Only 24.3% (25/102) of patients were referred and seen by ENT, 14.6% (15/102) of which had an interval PET scan and 8.7% (9/102) proceeded to tissue diagnosis. There was one oropharyngeal cancer identified and one unexpected metastasis from esophageal cancer. Conclusion Incidental uptake on PET/CT in the oropharynx is common. However, malignancy is rare (1.9%) and, when present, is associated with high SUVmax and asymmetrical uptake. Imaging results must be correlated clinically. These patients should be seen by an ENT specialist yet most may not require further investigations.

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Incidental findings on 18-FDG PET–CT in head and neck cancer. A retrospective case-control study of incidental findings on 18-FDG PET–CT in patients with head and neck cancer

Cited by 9 publications

References 8 publications

Whole‐body hybrid positron emission tomography imaging yields clinically relevant information in the staging and restaging of sinonasal tumors

Whole‐body hybrid positron emission tomography imaging yields clinically relevant information in the staging and restaging of sinonasal tumors

Incidental findings in the thyroid gland on computed tomography images of the oral and maxillofacial region

Incidental uptake of fluorodeoxyglucose in the Waldeyer’s ring and risk of oropharyngeal malignancy

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