The role of PET/CT in the management of head and neck squamous cell carcinoma

El-Khodary, Mohamed; Tabashy, Reda; Omar, Walid; Mousa, Amr; Mostafa, Ahmed

doi:10.1016/j.ejrnm.2011.05.006

Cited by 9 publications

(16 citation statements)

References 40 publications

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“…In today’s era of routine PET imaging and, therefore, increased staging accuracy, the possibility of delivering radiotherapy to a patient who harbours contralateral nodal disease is presumably lower. In fact, El Khodary, et al, have shown that PET-CT yields additional diagnostic information in just under half of HNSCC patients and can modify the radiotherapy plan in up to a quarter [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Patterns of Relapse in Squamous Cell Carcinoma of the Tonsil - Unilateral vs. Bilateral Radiation in the HPV-Era

Ye¹,

Bradley²,

Kader³

et al. 2015

Cureus

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Objectives: In the pre-human papillomavirus (HPV) era, unilateral radiation therapy (URT) for tonsil cancer was associated with low contralateral failure rates and had less toxicity than bilateral radiation therapy (BRT). This study explores the validity of URT in HPV-positive tonsil cancers.Methods: Tonsil squamous cell carcinomas (SCC) treated (typically with 70 Gy radiation and Cisplatin-based chemotherapy) between 2001 and 2007 were reviewed. Retrospective p16 immunohistochemistry staining was undertaken. Baseline, treatment, and response data were collected.Results: Of 182 patients, 78% were p16-positive, were younger (predominantly male), mostly former or non-smokers, and had a more advanced nodal stage. With a median follow-up of 68 months, contralateral recurrence (CLR) rates were low (3.5% p16-positive versus 2.5% p16-negative, p=0.63). Overall survival (OS) was 74% for p16-positive versus 54% for p16-negative subjects (p=0.01), but all other outcomes were similar. Analysis amongst only p16-positive subjects revealed URT was delivered to 37%, with CLR rates of 7.5% versus 1.1% for those treated with BRT, p=0.05. Of the four p16-positive subjects treated with URT who developed contralateral recurrences, three were managed with neck dissection (two disease-free and one died of lung metastases) and one received palliative radiation to the neck and distant metastatic site. All disease control and survival outcomes were similar between those treated with URT versus BRT.Conclusion: While CLRs remain rare overall, there appears to be a slightly increased rate among HPV-positive subjects treated with URT. However, overall outcomes do not appear to be impacted, suggesting that URT remains a reasonable approach in HPV-positive subjects.

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Section: Discussionmentioning

confidence: 99%

Patterns of Relapse in Squamous Cell Carcinoma of the Tonsil - Unilateral vs. Bilateral Radiation in the HPV-Era

Ye¹,

Bradley²,

Kader³

et al. 2015

Cureus

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“…We obtained the pooled OR value of 3.088 with 95% CI of [1.486; 6.419]. Data used for this analysis were heterogeneous, and we achieved the Q value of 33.8%, df value of 13, I 2 value of 61.5% (31.23-78.5), 2011 10 Pereira et al 2012 11 Karapolat and Kumanlıoğlu 2012 12 Gődény et al 2016 13 Ceylan et al 2018 14 Sherif et al 2018 15 Schroeder et al…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

“…Demographic summary of the patients and event data of the included studies are summarized in Table 1. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Two authors (XN and JZ) scanned the relevant sources for related studies separately. Mainly, the full-texts articles of the sources were collected, and abstracts were used to obtain sufficient information for the meta-analysis.…”

Section: Search Strategymentioning

confidence: 99%

“…Among these, the use of 18 F-FDG PET (PET with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG)) is highly recommended in various studies due to its high sensitivity for detecting perineural spread and recurrent metastatic tumors. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] For example, Schroeder et al reported that MRI and 18 F-FDG PET have identical detection rates of recurrent metastatic tumors. 16 Similarly, Lee et al reported that the application of 18 F-FDG PET in clinical diagnosis could enhance the tumor detection rate in head and neck cancers.…”

Section: Introductionmentioning

confidence: 99%

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Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

Nie¹,

Zhou²,

Zeng³

et al. 2022

Adv Clin Exp Med

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Background. Perineural spread of head and neck tumors is linked to a worse chance of survival as well as a higher risk of local recurrence and metastasis. Particle emission tomography/computed tomography (PET/CT) using 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) is part of the work-up and follow-up of many afflicted patients, and radiologists play an essential role in the assessment and management of head and neck cancer.Objectives. The purpose of the current study was to investigate the diagnostic performance of 18 F-FDG PET in detecting perineural spread among patients with head and neck tumors through a meta-analysis. Materials and methods.Relevant articles were searched using appropriate keywords from PubMed, MEDLINE and PubMed Central (PMC) databases. Retrospective and prospective studies were included as per the predefined PICOS criteria. Demographic summary and event data for diagnostic accuracy of 18 F-FDG PET were determined, and odds ratio (OR), sensitivity, specificity, likelihood ratios, and predictive values were calculated using RevMan software. The bias risk was analyzed with Egger's and Begg's tests using MedCalc software. Results.Fourteen clinical trials performed between 2000 and 2021, with 977 head and neck cancer patients with perineural spread, were included according to the inclusion criteria. Included studies used 18 F-FDG PET imaging of tumors and reported its high sensitivity. In the current study, we obtained the pooled OR = 3.088 (95% confidence interval (95% CI): [1.486; 6.419]), pooled sensitivity of 91.7%, pooled specificity of 92.35%, positive predictive value (PPV) of 92.27%, negative predictive value (NPV) of 91. 13%, positive likelihood ratio of 7.45, negative likelihood ratio of 0.28, disease prevalence of 95.8%, and accuracy of 91.5%. Data was heterogeneous, with Q value of 33.8%, degrees of freedom (df) value of 13, I 2 value of 61.5% (31.23-78.5), and p-value = 0.0013. The risk of publication bias was low, with a p = 0.7490 (Egger's test) and p = 0.7843 (Begg's test).Conclusions. The present meta-analysis highly recommends 18 F-FDG PET as an effective imaging method for patients with head and neck tumors with perineural spread.

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“…There is evidence to state that indicators of FDG metabolism such as maximal and mean standardized uptake value (SUV max and SUV mean ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) can predict disease-free survival. [678] Therefore, PET and measurements of FDG-related glucose metabolism may have prognostic benefit in these patients. Against this background and since available literature on prognostic evaluation of head and neck cancer using PET-CT in Indian population is sparse, available data in our institute were retrospectively analyzed to assess the prognostic value of PET-CT in locally advanced head and neck cancer patients, who had received concurrent chemoradiation.…”

Section: Introductionmentioning

confidence: 99%

The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy

Srinivas

Arunan

Venkatachalapathy

et al. 2019

J Int Soc Prevent Communit Dent

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Aims and Objectives: This retrospective study aims at correlating the pre- and post-therapy maximal standardized uptake values (SUV max ) of the whole-body 18-flourodeoxy glucose positron emission tomography (FDG-PET) scan with tumor response in patients with head and neck squamous cell cancer undergoing chemoradiotherapy. Materials and Methods: Data for this retrospective study were taken from the clinical records of 20 evaluable head and neck cancer patients who had availed treatment and evaluation at our institute during the previous year (March 2017–April 2018). All these above-mentioned patients had undergone chemoradiation at our center for locally advanced squamous cell carcinoma of the head and neck and had undergone pre- and post-therapy whole-body FDG PET scan. The posttherapy PET-computed tomography (CT) was advised after 8 weeks’ postcompletion of therapy. During the PET CT scan, images were acquired 1 h after injection of FDG. Pre- and post-therapy SUV max were recorded and correlated with immediate treatment response. Results: The mean pretherapy SUV Max of the primary tumor was 10.27 ranging from 4.5 to 26.17. The mean pretherapy SUV Max of the node was 5.34 ranging from 0 to 17.9. The mean time of recording the posttherapy SUV Max was 3 months (range 2–5 months). The mean posttherapy SUV Max of the primary tumor was 1.05 ranging from complete metabolic response to 6.4. The mean posttherapy SUV Max of the node was 0.7 ranging from complete metabolic response to 5.43. The statistical analysis based on Wilcoxon–Signed Rank test revealed a statistically significant difference in the pre- and post-therapy SUV max values for both primary tumor ( P < 0.001) and regional node ( P = 0.001). Majority of patients ( n = 15) showed clinical remission; however, five patients had progressive disease at the time of evaluation. Conclusion: Although the retrospective study revealed that complete responders had a statistically significant reduction in the posttherapy SUV max in comparison to the pretherapy SUV max it failed to identify a cutoff value for pretherapy SUV max which could predict the probable outcome of therapy. In view of the same further prospective studies need to be conducted with larger patient numbers including various other tumor metabolic markers for greater clarity.

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The role of PET/CT in the management of head and neck squamous cell carcinoma

Cited by 9 publications

References 40 publications

Patterns of Relapse in Squamous Cell Carcinoma of the Tonsil - Unilateral vs. Bilateral Radiation in the HPV-Era

Patterns of Relapse in Squamous Cell Carcinoma of the Tonsil - Unilateral vs. Bilateral Radiation in the HPV-Era

Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy

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