Differentiating osteoradionecrosis from nasopharyngeal carcinoma tumour recurrence using ⁹⁹Tcm-sestamibi SPECT/CT

Osteoradionecrosis (ORN) of the base of skull is a known complication of external beam radiotherapy in the treatment of nasopharyngeal carcinoma, and is widely believed to be sequelae of radiation-induced endarteritis, leading to cellular death and fibrosis. Differentiating ORN from tumour recurrenc...

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Bibliographic Details
Published in:British journal of radiology 2011-09, Vol.84 (1005), p.e172-e175
Main Authors: Tan, A E H, Ng, D C E
Format: Article
Language:English
Subjects:
Aged
Bone imaging
Carcinoma, Squamous Cell - diagnostic imaging
Carcinoma, Squamous Cell - radiotherapy
Case Report
Complications
Computed tomography
Diagnosis, Differential
Endarteritis
Fibrosis
Fluorodeoxyglucose F18
Humans
Male
Nasopharyngeal carcinoma
Nasopharyngeal Neoplasms - diagnostic imaging
Nasopharyngeal Neoplasms - radiotherapy
Neoplasm Recurrence, Local - diagnostic imaging
Osteoradionecrosis
Osteoradionecrosis - diagnostic imaging
Osteoradionecrosis - pathology
Radiopharmaceuticals
Radiotherapy
Scintigraphy
Single photon emission computed tomography
Skull
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed, Single-Photon - methods
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Osteoradionecrosis (ORN) of the base of skull is a known complication of external beam radiotherapy in the treatment of nasopharyngeal carcinoma, and is widely believed to be sequelae of radiation-induced endarteritis, leading to cellular death and fibrosis. Differentiating ORN from tumour recurrence is challenging and has direct clinical implications. We present a case where (99)Tc(m)-sestamibi SPECT/CT was used to differentiate ORN from tumour recurrence and in which prior imaging using bone scintigraphy and fluorodeoxyglucose PET/CT were equivocal.
ISSN:0007-1285
1748-880X
DOI:10.1259/bjr/60136051