Head and neck cancer patients with pulmonary nodules: Value and role of CT‐guided transthoracic needle aspiration biopsies

Mesurolle, Benoı̂t; Mignon, F; Meingan, P.; Domenge, C.; Vasile, Manuella; Sigal, R.

doi:10.1002/hed.10303

Cited by 10 publications

(6 citation statements)

References 31 publications

(41 reference statements)

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“…Brouwer et al 11 reported that pulmonary lesions were considered malignant if unequivocal radiologic findings were identified on chest CT or if progression of the lesions was demonstrated on a follow-up scan. In our study, lung biopsy was performed in only 8 of 49 patients (16.3%) with multiple and peripheral pulmonary nodules, as Mesurolle et al 14 and Ginsberg et al 15 demonstrated more than 90% malignant results in such lesions. However, 2 false-positive CT scans were encountered in the present study.…”

Section: Commentmentioning

confidence: 66%

Role of Chest Computed Tomography in Head and Neck Cancer

Hsu

Chu

Liu

et al. 2008

Arch Otolaryngol Head Neck Surg

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To evaluate the role of chest computed tomography (CT) in patients with head and neck squamous cell carcinoma (HNSCC) and to determine the optimal timing and predictive factors for positive findings. Design: Retrospective analysis. Setting: Tertiary referral center. Patients: Two hundred seventy screening chest CT scans performed in 192 patients with HNSCC during a 42month period were reviewed. Main Outcome Measures: The scans were categorized as new cases, follow-up cases, or recurrent cases. The results were classified as abnormal or normal. Scans of patients having a radiologic diagnosis of a malignant neoplasm of the lung or an indeterminate lesion were considered abnormal. Factors correlating with an abnormal chest CT scan or development of malignant neoplasm of the lung were analyzed, including the timing of imaging and the patients' clinicopathologic data. Results: Seventy-nine scans (29.3%) were considered abnormal. The rate of an abnormal scan was significantly higher in the follow-up case group (44.2%) than in the new case group (14.2%) (P Ͻ.001). Ten of 15 indeterminate scans (66.7%) with small (Ͻ1 cm) solitary pulmonary nodules showed disease progression on subsequent follow-up scans, changing the patients' diagnoses to a malignant neoplasm of the lung. The predictive factors for development of a malignant neoplasm of the lung were initial N2 or N3 disease, stage IV disease, recurrent disease, and distant metastasis to another site. Conclusions: Chest CT is recommended for high-risk patients, especially during the follow-up period. Intensified evaluation and management are mandatory for indeterminate small solitary pulmonary nodules because of the high rate of malignant neoplasms.

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Section: Commentmentioning

confidence: 66%

Role of Chest Computed Tomography in Head and Neck Cancer

Hsu

Chu

Liu

et al. 2008

Arch Otolaryngol Head Neck Surg

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“…Scarring and post-operative changes complicate interpretation of CT images and needle biopsy results are inconclusive in up to 30% patients (Mesurolle et al, 2003). Metabolic imaging with PET/CT however shows a high accuracy (between 78 and 98%) in post-therapy NSCLC for recurrence detection (Erasums and Patz, 1999).…”

Section: Pet/ct-based Radiation Therapy Follow-up and Recurrence Detementioning

confidence: 99%

Current concepts in F18 FDG PET/CT-based radiation therapy planning for lung cancer

Lee¹,

Kupelian²,

Czernin³

et al. 2012

Front. Oncol.

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Radiation therapy is an important component of cancer therapy for early stage as well as locally advanced lung cancer. The use of F18 FDG PET/CT has come to the forefront of lung cancer staging and overall treatment decision-making. FDG PET/CT parameters such as standard uptake value and metabolic tumor volume provide important prognostic and predictive information in lung cancer. Importantly, FDG PET/CT for radiation planning has added biological information in defining the gross tumor volume as well as involved nodal disease. For example, accurate target delineation between tumor and atelectasis is facilitated by utilizing PET and CT imaging. Furthermore, there has been meaningful progress in incorporating metabolic information from FDG PET/CT imaging in radiation treatment planning strategies such as radiation dose escalation based on standard uptake value thresholds as well as using respiratory-gated PET and CT planning for improved target delineation of moving targets. In addition, PET/CT-based follow-up after radiation therapy has provided the possibility of early detection of local as well as distant recurrences after treatment. More research is needed to incorporate other biomarkers such as proliferative and hypoxia biomarkers in PET as well as integrating metabolic information in adaptive, patient-centered, tailored radiation therapy.

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“…The complication and malignancy rates associated with lung workup in this study are in accordance with the results demonstrated by other studies. 31,32 The additional treatment delay in patients who underwent a workup was due in part to prolonged hospital courses and associated hospital deconditioning. Twenty-seven percent of patients who underwent workup had at least a 2-day hospital stay, and several patients were admitted for 5 days post procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The complication and malignancy rates associated with lung workup in this study are in accordance with the results demonstrated by other studies. 31,32…”

Section: Discussionmentioning

confidence: 99%

Workup of Suspected Chest Metastases on ¹⁸F-FDG-PET/CT in Head and Neck Cancer: Worth the Wait?

et al. 2019

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The objective of our study is to assess the impact of equivocal or positive positron emission tomography combined with low-dose noncontrast computed tomography (PET/CT) findings in the chest on treatment for head and neck cancer (HNC). We reviewed charts of patients presented at Augusta University’s Head and Neck Tumor Board (AUTB) between 2013 and 2016 with the following exclusion criteria: <18 years, Veterans Affairs patients, those with incomplete data, and those without a history of head and neck squamous cell carcinoma. The lung/thorax sections of the radiologists’ PET/CT reports were graded as “Positive, Equivocal, or Negative” for chest metastases. Patients who underwent workup for suspected chest metastases were assessed for treatment delays, changes in treatment plans, and complications. In addition, we evaluated the time between AUTB presentation and peri-treatment PET/CT to primary treatment initiation were calculated between groups. There was a total of 363 patients with PET/CT prior to treatment, the read was “Negative” in 71.3% (n = 259), “Equivocal” in 20.9% (n = 76), and “Positive” in 5.8% (n = 21). Of 272 patients with complete treatment data, 22 underwent workup for suspected chest metastases. Mean time from PET/CT to treatment initiation was 27.5 days without workup and 64.9 days with workup ( P < .0001), and from AUTB presentation was 29.1 days without workup and 62.5 days with workup ( P < .0001). Five (19.2%) patients experienced a complication from workup. Twenty (76.9%) patients had no changes in their treatment plan after workup. In conclusion, our results for potential chest metastases on PET/CT in patients with HNC are often not clear-cut. Workup of suspected chest metastasis based on PET/CT findings significantly delays primary treatment initiation and may cause serious complications.

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Head and neck cancer patients with pulmonary nodules: Value and role of CT‐guided transthoracic needle aspiration biopsies

Abstract: In head and neck cancer patients, the prevalence of thoracic malignancies is high when a pulmonary lesion is detected. CT-guided biopsy of pulmonary lesion is an accurate procedure. However, a third of positive biopsies were categorized as indeterminate malignancies.

Cited by 10 publications

References 31 publications

Role of Chest Computed Tomography in Head and Neck Cancer

Role of Chest Computed Tomography in Head and Neck Cancer

Current concepts in F18 FDG PET/CT-based radiation therapy planning for lung cancer

Workup of Suspected Chest Metastases on ¹⁸F-FDG-PET/CT in Head and Neck Cancer: Worth the Wait?

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Head and neck cancer patients with pulmonary nodules: Value and role of CT‐guided transthoracic needle aspiration biopsies

Abstract: In head and neck cancer patients, the prevalence of thoracic malignancies is high when a pulmonary lesion is detected. CT-guided biopsy of pulmonary lesion is an accurate procedure. However, a third of positive biopsies were categorized as indeterminate malignancies.

Cited by 10 publications

References 31 publications

Role of Chest Computed Tomography in Head and Neck Cancer

Role of Chest Computed Tomography in Head and Neck Cancer

Current concepts in F18 FDG PET/CT-based radiation therapy planning for lung cancer

Workup of Suspected Chest Metastases on 18F-FDG-PET/CT in Head and Neck Cancer: Worth the Wait?

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Workup of Suspected Chest Metastases on ¹⁸F-FDG-PET/CT in Head and Neck Cancer: Worth the Wait?