The diagnostic value of positron emission tomography (PET) with radiolabelled fluorodeoxyglucose (18F-FDG) in head and neck cancer

• Published in: Journal of laryngology and otology 1999-06, Vol.113 (6), p.548-554
• Main Authors: Slevin, N. J., Collins, C. D., Hastings, D. L., Waller, M. L., Johnson, R. J., Cowan, R. A., Birzgalis, A. R., Farrington, W. T., Swindell, R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - radiotherapy; emission-computed; Ent. Stomatology; Female; Fluorodeoxyglucose F18; Head and neck neoplasms; Head and Neck Neoplasms - diagnostic imaging; Head and Neck Neoplasms - radiotherapy; Humans; Investigative techniques, diagnostic techniques (general aspects); Laryngeal Neoplasms - diagnostic imaging; Laryngeal Neoplasms - radiotherapy; Magnetic Resonance Imaging; Main Articles; Male; Medical sciences; Middle Aged; Nose Neoplasms - diagnostic imaging; Nose Neoplasms - radiotherapy; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Pilot Projects; Predictive Value of Tests; Prospective Studies; Radionuclide investigations; Radiopharmaceuticals; Tomography; Tomography, Emission-Computed; Tonsillar Neoplasms - diagnostic imaging; Tonsillar Neoplasms - radiotherapy; Tumors
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215100144457

Positron emission tomography (PET) scanning has recently been introduced into clinical practice but its usefulness in the management of head and neck cancer is not well defined. The aim of this prospective preliminary study was to examine the clinical value of fluorodeoxyglucose (FDG) – PET in patients with head and neck cancer treated by radiotherapy with surgery in reserve by (i) relating quantitative uptake of isotope to tumour type and histological grade and (ii) comparing the imaging findings of PET and magnetic resonance imaging (MRI) in post-radiotherapy assessment of tumour response. Twenty-one patients had pre-treatment PET and MRI scans and these were repeated four and eight months after treatment if there was no clinical relapse. Pre-treatment uptake of FDG using tumour to cerebellar ratio parameters was significantly related to the histological grade of squamous cancer (p = 0.04) but not to tumour type. Discordance of post-treatment PET/MRI findings in one case indicates a possible role for PET in the early detection of tumour recurrence. Other potential uses of PET scanning in the management of head and neck cancer are discussed.