Role of PET/CT in Evaluation of Neck Tumors

Abstract

Morphologic imaging with computed tomography (CT) and/or magnetic resonance imaging (MRI) with intravenous contrast are often performed to noninvasively assess the aerodigestive tract or to provide information about primary tumor size, infiltration, involvement of surrounding structures, and regional nodal involvement. There is growing evidence, however, that these modalities have limitations in their diagnostic accuracy Since primary therapy is thus the only curative treatment option for the patient, its optimization must be assigned top priority. The present study shows that FDG-PET/CT images for primary head and neck carcinoma had a potential impact on both tumor staging and treatment planning. Based on data as well as the other literature results, the future scenario of imaging for radiotherapy of head and neck tumors may include the use of functional imaging such as FDG-PET/CT with the aim to characterize the biological features of the tumor and optimize the use of highly conformal and biologically effective radiation treatment. FDG-PET/CT in head and neck cancer yielded additional diagnostic information in patients, with subsequent modification of treatment strategy and implementation of further curative therapy. Based on the findings of FDG-PET/CT, modification of RT was performed and treatment plane change of the patients, Therefore, the implementation of FDG-PET/CT to refine and optimize the baseline staging head and neck cancer is indubitably useful and justifiable. PET/CT is an effective noninvasive diagnostic tool for the assessment of head and neck carcinoma, with an overall diagnostic accuracy of 92%. PET/CT was significantly superior to CT concerning diagnostic accuracy in patients with head and neck cancer for assessment of treatment response and recurrent disease, with specificity, sensitivity, NPV, PPV, and accuracy of 27%, 74%,30%,71%,60% consecutively for CT and 91%,92%,83%,96%, and 92% consecutively for PET/CT. The advent of PET/CT now permits the evaluation of both metabolic and anatomic characteristics of disease, which has proven to be a major advance for treatment monitoring, and evaluation of residual or recurrent HNC. The metabolic-anatomic information from co-registered FDG-PET/CT provides accurate assessment of treatment response. FDG-PET/CT excels by a higher specificity and overall diagnostic performance than current CT imaging. A FDG-PET/CT-based strategy to assess treatment response after radiation therapy might allow for further individualized treatment stratification. Results suggest a potential clinical role of FDG-PE