Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study

Abstract

Background: Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been proven to be a good method to detect distant spread of head and neck cancer (HNC). However, most prior studies are based on Asian populations and may not be directly transferable to western populations. Purpose: To investigate the frequency and distribution of distant metastases and synchronous malignancies detected by PET/CT in HNC in a northern Swedish population. Material and Methods: All primary whole-body FDG-PET/CT examinations performed on the suspicion of HNC (n ¼ 524 patients) between 1 January 2013 and 31 December 2016 at Umeå University Hospital in Sweden were retrospectively reviewed . After the exclusion of 189 examinations without evidence of primary HNC, 335 examinations were analyzed. Results: Distant metastases were detected in 10 (3%) patients, all with advanced primary tumors corresponding to TNM stage 3-4, most frequently in salivary gland adenocarcinoma, where 50% of patients had distant spread. Four patients had metastases below the diaphragm, representing 20% of the salivary gland malignancies. In the remaining six patients, metastases were supraphrenic, of which all but one were identified by CT alone. Synchronous malignancies were discovered in 14 (4.2%) patients, of which five were below the diaphragm. Conclusion: The overall frequency of distant spread and synchronous malignancy in primary HNC was generally low. However, the risk for distant metastases below the diaphragm was relatively higher in salivary gland adenocarcinoma, supporting whole-body FDG-PET/CT in the primary diagnostic work-up in these patients.

The Relevance of Osteoscintigraphy Technique in Early Detection of Bone Metastatic Lesions: a Systematic Review

“…Наибольшие затруднения составляют сложные для обнаружения локализации, такие как кости че репа и таза, позвонки [17], что служит предпосыл кой к использованию других лучевых методик, одна из которых -КТ. В связи с отсутствием артефактов от дыхательных движений такое исследование яв ляется более точным, чем МРТ [18,19]. Также на блюдается отсутствие перекрывания структур, ха рактерного для рентгенографии.…”

PET/MR versus PET/CT for locoregional staging of oropharyngeal squamous cell cancer

“…One drawback of FDG-PET/MR is that whole-body MRI is more technically challenging and requires more time to perform than whole body FDG-PET/CT (21). In a recent study, we found that for small HNC tumors (T1-T2) with a clinically negative neck, the risk for distant metastasis is extremely low and no squamous cell carcinomas (SCCs) in a cohort of 335 cases had set subphrenic metastases (22). On the other hand, whole-body imaging with PET/CT in early stage HNC can trigger excessive investigations of benign abdominal lesions that can cause delays in treatment (23,24).…”