Contrast‐enhanced 18F‐<scp>FDG</scp>‐<scp>PET</scp>/<scp>CT</scp> for Differentiating Tumour and Radionecrosis in Head and Neck Cancer: Our experience in 37 Patients

Meerwein, Christian; Nakadate, Masashi; Stolzmann, Paul; Vital, Domenic; Morand, G; Zweifel, Daniel; Huber, Gerhard; Huellner, Martin W.

doi:10.1111/coa.13185

Cited by 5 publications

(7 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The latter is sometimes very hard to distinguish from tumor recurrence on cross-sectional imaging alone. A previous study by our group showed that a combination of low SUV max and location of the hottest voxel inside bone/cartilage enables differentiation from tumor recurrence 32 .…”

Section: Discussionmentioning

confidence: 95%

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Stadler

Hüllner

Broglie

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

18-flurodesoxyglucose position emission tomography (FDG-PET) with computed tomography (CT) or magnetic resonance imaging (MRI) is a broadly accepted tool for pretherapeutic staging and post-therapeutic assessment of response. The prognostic value of sequential post-therapeutic FDG-PETs and the impact of change in metabolic activity has been scarcely reported so far. We hypothesized that an increase in metabolic activity (as measured by maximum standardized uptake value, SUVmax) would be predictive for recurrence. We retrospectively assessed all oral, oropharyngeal, laryngeal, and hypopharyngeal squamous cell carcinoma patients treated at the Department of Otorhinolaryngology—Head and Neck Surgery, University Hospital Zurich between April 1st, 2010 and September 30th, 2018 (N = 337). After a negative post-treatment FDG-PET at 3 months, we measured the SUVmax of the local tumor area and the regional lymph nodes on follow-up FDG-PET at 9 months. We then correlated SUVmax difference between 9 and 3 months with tumor recurrence using Kaplan Meier analysis. During follow-up, 68 patients (20.2%) had local recurrence and 53 had regional recurrence (15.7%) at a median time of 9.0 (IQR 4.25–14) and 7.0 (IQR 5.25–23) months, respectively. An increase in local and/or regional SUVmax from the 3 months to the 9 months post-therapeutic FDG-PET resulted in a poorer recurrence-free survival (Log rank, P = 0.001, for both). An increase in local SUVmax between 3 and 9 months was associated with a hazard ratio of 4.17 for recurrence (95%CI 1.89–9.2, P = 0.0003). In conclusion, an increase in metabolic activity/SUVmax between two post-therapeutic FDG-PETs requires a histological examination as it is associated with tumor recurrence.

show abstract

Section: Discussionmentioning

confidence: 95%

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Stadler

Hüllner

Broglie

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…PET/CT findings of ORN reflect the disease course and indicate the point of clinical remission in patients with chronic osteomyelitis [40][41][42]. PET is effective in detecting tumor recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of trismus would improve with surgical resection of the necrotic bone, however, with only conservative treatments, it is unclear whether trismus can be improved. PET/CT findings of ORN reflect the disease course and indicate the point of clinical remission in patients with chronic osteomyelitis [40][41][42]. PET is effective in detecting tumor recurrence.…”

Section: Discussionmentioning

confidence: 99%

Clinical Diagnostic Imaging Study of Osteoradionecrosis of the Jaw: A Retrospective Study

Miyamoto

Tanaka

Kogi

et al. 2021

JCM

View full text Add to dashboard Cite

Radiation therapy (RT) plays a significant role in the management of head and neck malignancies. This study aimed to review the clinical symptoms and various imaging findings of osteoradionecrosis (ORN) and provide a clinical perspective on the development of ORN. The retrospective cohort was composed of 57 sites in 54 patients who had a history of RT and suspected ORN and 48 sites in 45 patients who were confirmed to have ORN. Image analyses included computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, bone scintigraphy, and single-photon emission CT (SPECT). The irradiated tissue was damaged by RT, and the extent of damage was correlated with clinical symptoms. The bone marrow showed sclerotic changes and the devitalized bone showed bone resorption after invasive stimulation. Chronic trismus and pathological fracture are considered severe conditions, typically occurring in the last stage of ORN. Furthermore, neurological symptoms were an important sign of tumor recurrence, since diagnostic imaging was difficult. The possible treatment options vary depending on the stage of ORN. We speculate that bone sclerosis reactions and bone resorption are sequential reactions that seem to be protective measures of the bone to radiation injury.

show abstract

“…Thus, FDG uptake and percussion pain were not associated with each other. FDG uptake may also occur in acute infective exacerbations of chronic inflammatory processes of the jaw, such as osteonecrosis [22,23]. Various studies have assessed the short-term and long-term oral complications of radiochemotherapy in patients with HNC and the rationale for focus assessment prior to cancer therapy [8,24,25].…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

FDG-PET/CT for oral focus assessment in head and neck cancer patients

et al. 2022

View full text Add to dashboard Cite

Objectives To compare oral and maxillo-mandibular inflammatory foci on standard oral radiographs (OPT, periapical radiograph) with available fluorine-18-labelled fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) data and to discuss whether additional metabolic information derived from FDG-PET/CT can support oral care specialists when performing oral focus examinations. Materials and methods Data from 23 patients with head and neck cancer who underwent FDG-PET/CT and panoramic and periapical radiography in close succession before first-line radiotherapy and/or chemotherapy were included in this exploratory retrospective study. Periapical lesions and marginal periodontal inflammation on FDG-PET/CT scans and standard oral radiographs were analysed and compared with regard to metabolic activity on FDG-PET/CT in comparison to recorded clinical symptoms and radiological scores. Additionally, inflammatory maxillo-mandibular pathologies were analysed using FDG-PET/CT. Results The maximum standardised uptake value (SUVmax) in FDG-avid marginal periodontal sites could not be conclusively associated with the radiologically recorded severity of marginal bone loss, but a potential positive correlation was identified. No association was found either between the metabolic activity of periapical lesions and their extent, as recorded on standard oral radiographs, or regarding clinical symptoms (percussion test). Most maxillo-mandibular pathologies did not show increased FDG uptake. Conclusions FDG-PET/CT provided additional metabolic information that can help clinicians identify lesions with increased inflammatory activity. The incorporation of available oral FDG-PET/CT findings into the primary oral focus assessment may allow for more accurate oral focus treatment. Clinical relevance FDG-PET/CT provides valuable metabolic information for oral care specialists. The detection of inflammatory oral processes using FDG-PET/CT facilitates treatment.

show abstract

Contrast‐enhanced 18F‐FDG‐PET/CT for Differentiating Tumour and Radionecrosis in Head and Neck Cancer: Our experience in 37 Patients

Cited by 5 publications

References 9 publications

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Clinical Diagnostic Imaging Study of Osteoradionecrosis of the Jaw: A Retrospective Study

FDG-PET/CT for oral focus assessment in head and neck cancer patients

Contact Info

Product

Resources

About