Use of¹⁸F-Fludeoxyglucose–Positron Emission Tomography/Computed Tomography for Patient Management and Outcome in Oropharyngeal Squamous Cell Carcinoma

Abstract

18F-fludeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has been performed widely in diagnosis and management of patients with oropharyngeal squamous cell carcinoma (OPSCC). This review summarizes the literature on this tool in the management of these patients. The use of FDG-PET/CT helps in accurate staging of primary tumor, nodal involvement, and distant metastasis of patients with OPSCC. Contrast-enhanced FDG-PET/CT combines high-resolution CT and functional FDG-PET, providing the optimum imaging information for patient management. Using contrast-enhanced PET/CT leads to a combined anatomic and metabolic approach to radiation therapy planning in OPSCC. Moreover, PET/CT not only is a good modality for therapy assessment but also is a powerful tool in early recurrence detection of OPSCC. Finally, the PET/CT parameters provide survival information in patients with OPSCC; however, further studies are needed to introduce a scoring system to use clinically for prognosis prediction.

Glucose Metabolism and Its Complicated Relationship with Tumor Growth and Perfusion in Head and Neck Squamous Cell Carcinoma

“…Positron-emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) depicts the tumor metabolic rate of glucose. The tumor metabolic rate is one of the important factors that reflect tumor aggressiveness, and thus the determination of a tumor’s FDG uptake has been reported to improve the accuracy of the diagnosis, staging, and detection of recurrence in HNSCCs [1, 2]. The TBF has also been reported to reflect tumor characteristics such as tumor neo-angiogenesis, and has thus been found to be useful for the pretreatment assessments of patients' need for chemoradiotherapy, and for therapeutic monitoring [3, 4].…”

Post-treatment 18F-FDG-PET/CT versus contrast-enhanced CT in patients with oropharyngeal squamous cell carcinoma

“…After treatment of OPSCC with surgical resection, chemotherapy or radiation therapy, changes in the normal tissue and anatomy (edema, hyperemia, and fibrosis) may affect the accuracy of imaging modalities in detecting residual disease[1]. Therapy assessment is an important step in the management of patients with OPSCC; since accurate confirmation of complete response can lead to discontinuing treatment.…”

“…In another study, ultrasound (US) MRI and PET/CT were evaluated in detection of neck residual disease in patients with OPSCC and concluded that PET/CT combined with neck US could be a reliable and cost effective strategy in this setting [36]. In term of CT scan, neck CECT scans could not differentiate between the residual disease and therapy related changes such as necrotic and scar tissue [1,37]. Finally, dental repair materials, i.e.…”

“…Oropharyngeal squamous cell carcinoma (OPSCC) is the most common subtype of head and neck cancers, with an incidence of 12,000 new cases annually in the United States [1,2]. Although the incidence of other head and neck cancers decreased in the last decade, the number of patients with OPSCC has increased due to oral HPV infections.…”

Clinical Indications and Impact on Management: Fourth and Subsequent Posttherapy Follow-up 18F-FDG PET/CT Scans in Oncology Patients

“…The role of 18 F-FDG PET/CT imaging in initial staging, therapy planning, and therapy assessment of different cancers has been well established (14)(15)(16)(17)(18)(19)(20). Multiple studies claimed that follow-up 18 F-FDG PET/CT scanning is valuable when there is a clinical suspicion of disease recurrence.…”