The role of PET/CT in the management of patients affected by head and neck tumors: a review of the literature

Abstract

The management of head and neck tumor (HNSCC) has been changing over the years, especially due to the aid of imaging techniques that help physicians to attain a correct diagnosis. These techniques represent a valuable tool to help tailor treatment and during follow-up of patients affected by malignancies. The aim of this review is to summarize the results of the most recent and relevant studies about the use of PET imaging in HNSCCs. This review is divided into six chapters: (1) The role of PET/CT in the pre-treatment phase; (2) PET/CT and radiotherapy planning; (3) PET/CT in the post-treatment setting; (4) PET/CT and SUVmax for prediction of prognosis; (5) miscellanea on the utility of PET in specific HNSCCs; (6) non-FDG PET tracers used in HNSCC. Promising results have been obtained so far. Despite the encouraging outcomes, more investigations are needed to warrant the value of this technique, especially in the pre-treatment setting.

Utility of first positron emission tomography‐computed tomography scan as a prognostic tool following treatment of sinonasal and skull base malignancies

“…[4][5][6][7][8][9][10][11] An important advantage of PET/CT is that a whole-body scan allows for the detection of distant metastases and unexpected secondary cancers. Positron emission tomography (PET) and, in particular, combined PET-computed tomography (PET/CT) have become popular as useful diagnostic and prognostic tools for pretreatment staging, radiotherapy planning, measuring treatment response for residual or recurrent disease, and monitoring posttreatment follow-up results in various head and neck malignancies.…”

“…residual or recurrent disease, and monitoring posttreatment follow-up results in various head and neck malignancies. [4][5][6][7][8][9][10][11] An important advantage of PET/CT is that a whole-body scan allows for the detection of distant metastases and unexpected secondary cancers. The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for head and neck cancers have been updated to include PET/CT as a supplement to the clinical evaluation in the posttreatment surveillance of head and neck squamous cell carcinoma (HNSCC) patients.…”

Non-18F-FDG PET/CT in the management of patients affected by HNC

“…The assessment of tumour hypoxia is an important issue in clinical management in HNC as patients with hypoxic tumours generally have poorer outcome, show resistance to conventional treatment and could be treated selectively with tailored treatments [11]. Specific treatment may include the use of tirapazamine (and hypoxiaselective cytotoxin), radiosensitizers (e.g.…”

Prognostic significance of pretreatment 18F‐fluorodeoxyglucose positron emission tomography evaluation using metabolic tumor volume of the primary tumor and lymph nodes in advanced hypopharyngeal cancer

“…Parameters frequently used in analysis with FDG-PET examinations are the maximum standard uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). [5][6][7] Some studies noted the effectiveness of SUVmax, which is the most commonly used parameter in PET examinations, 8,9 whereas other studies showed that SUVmax had no significance as a predictor of prognosis in patients with head and neck tumors. 10,11 Thus, it can be thought that the utility of SUVmax as a predictor of prognosis in head and neck tumors is still controversial.…”