F-18 FDG PET-CT fusion in radiotherapy treatment planning for head and neck cancer

• Published in: Head & neck Vol. 27; no. 6; pp. 494 - 502
• Main Authors: Koshy, Mary, Paulino, Arnold C., Howell, Rebecca, Schuster, David, Halkar, Raghuveer, Davis, Lawrence W.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.06.2005; John Wiley & Sons
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - radiotherapy; Female; Fluorodeoxyglucose F18; functional imaging; head and neck cancer; Head and Neck Neoplasms - diagnostic imaging; Head and Neck Neoplasms - radiotherapy; Humans; Male; Medical sciences; Middle Aged; Neoplasm Staging; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; PET-CT; Positron-Emission Tomography; Radiopharmaceuticals; Radiotherapy Planning, Computer-Assisted; radiotherapy treatment planning; Retrospective Studies; staging; Tomography, X-Ray Computed; Tumors; Radionuclide study; Human; Radiodiagnosis; Stomatology; radiotherapy treatment planning; PET-CT; ENT; Malignant tumor; Radiotherapy; Treatment; Medical imagery; ENT disease; Head and neck cancer; Computerized axial tomography; Treatment planning; Positron emission tomography; staging; Functional imaging; Positron; Emission tomography
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.20179

Background. The fusion of fluoro‐2‐deoxy‐d‐glucose–positron emission tomography (FDG‐PET) with CT scans has been shown to improve diagnostic accuracy and staging in non‐small cell lung cancer. We report on the influence of PET‐CT fusion on the management of patients with head and neck cancer. Methods. Thirty‐six patients with intact primary head and neck cancers treated with radiation therapy (RT) received PET‐CT as part of treatment planning. Workup before PET‐CT included a contrast‐enhanced CT scan of the head and neck and chest X‐ray; patients with nasopharyngeal and paranasal sinus primary tumors also underwent MRI. Results. Changes in TNM score and American Joint Committee on Cancer stage occurred in 13 patients (36%) and five patients (14%), respectively, based on PET‐CT. RT volume and dose were altered in five patients (14%) and four patients (11%), respectively. Five patients initially were seen with carcinoma of unknown primary, and PET‐CT confirmed oropharyngeal primary tumors in two. PET‐CT data also detected a synchronous lung cancer in one patient. Conclusion. PET‐CT fusion may have a significant impact on staging and determination of RT treatment volume and dose. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005