PET-CT in Clinical Adult Oncology—V. Head and Neck and Neuro Oncology

Abstract

PET-CT is an advanced imaging modality with many oncologic applications, including staging, assessment of response to therapy, restaging, and longitudinal surveillance for recurrence. The goal of this series of six review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for specific oncologic indications, and the potential pitfalls and nuances that characterize these applications. In addition, key tumor-specific clinical information and representative PET-CT images are provided to outline the role that PET-CT plays in the management of oncology patients. Hundreds of different types of tumors exist, both pediatric and adult. A discussion of the role of FDG PET for all of these is beyond the scope of this review. Rather, this series of articles focuses on the most common adult malignancies that may be encountered in clinical practice. It also focuses on FDA-approved and clinically available radiopharmaceuticals, rather than research tracers or those requiring a local cyclotron. The fifth review article in this series focuses on PET-CT imaging in head and neck tumors, as well as brain tumors. Common normal variants, key anatomic features, and benign mimics of these tumors are reviewed. The goal of this review article is to provide the imaging professional with guidance in the interpretation of PET-CT for the more common head and neck malignancies and neuro oncology, and to inform the referring providers so that they can have realistic expectations of the value and limitations of PET-CT for the specific type of tumor being addressed.

The Diagnostic and Predictive Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Laryngeal Squamous Cell Carcinoma

“…In routine practice, the analysis of 18 F-FDG PET/CT images of the head and neck region is challenging [27,28]. The intricate anatomical composition of the head and neck region, its proximity to vital structures, and the potential overlap of physiological and pathological radiotracer uptake patterns make it difficult to accurately differentiate benign from metastatic LNs [29]. Moreover, several LN factors, including size and necrosis, that could lead to low metabolic activity contribute to the high incidence of false-negative findings on PET/CT [30].…”

Role of FDG-PET/CT in diagnosis and follow-up head and neck cancer

“…En la práctica clínica, según las guías actuales de la NCCN, en la valoración inicial de los CCC, la FDG PET/TC se reserva para los estadios avanzados (T3-4 o N1) debido a la alta probabilidad de encontrar enfermedad locorregional o diseminada en el momento del diagnóstico, que puede provocar cambios significativos en la actitud terapéutica, como evitar la realización de cirugías agresivas (6,19).…”

Retrospective Analysis of the Predictive Value of 18F-FDG PET/CT Metabolic Parameters for PD-L1 Expression in Cervical Cancer

“…However, it is always difficult for patients with recurrence and metastasis to obtain tumor tissues. 2-Deoxy-2-[ 18 F] fluoro-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) is acknowledged as an important non-invasive whole-body molecular imaging modality for evaluation of various tumors [ 7 , 8 , 9 , 10 , 11 , 12 ]. It has been reported that 18 F-FDG PET/CT could be used to predict multiple molecular phenotypes for malignant tumors, for instance, HER2 expression in gastric cancer [ 13 ], EGFR mutations and positive ALK expression in NSCLC [ 14 ].…”