Valor da PET/CT na abordagem do câncer de cabeça e pescoço

Abstract

Objective: To evaluate the role of PET/CT in the approach to patients with head and neck cancer. Materials and Methods: Retrospective study of medical records and PET/CT images of 63 patients with head and neck cancer. Results: Alterations were observed in 76% of the cases. Out of these cases, 7 (11%) were considered as false-positive, with SUV < 5.0. PET/CT demonstrated negative results in 15 cases (24%). Among the 14 cases where the method was utilized for staging, 3 (22%) had their stages changed. Conclusion: PET/CT has shown to be of potential value in the routine evaluation of patients with head and neck cancer, but further studies of a higher number of cases are required to define a protocol for utilization of the method. Keywords: Emission computed tomography; Fluorodeoxyglucose 18F; Head and neck neoplasms; Neoplasm staging; Squamous cell carcinoma.Objetivo: Avaliar a PET/CT na abordagem de pacientes com câncer de cabeça e pescoço. Materiais e Métodos: Estudo retrospectivo de 63 prontuários e exames de PET/CT de pacientes com câncer de cabeça e pescoço. Resultados: Foram encontradas alterações em 76% dos exames. Destes, 7 (11%) foram considerados falso-positivos, com SUV < 5,0. A PET/CT mostrou-se negativa em 15 situações (24%). Dos 14 casos nos quais se utilizou o exame para estadiamento, em 3 (22%) houve aumento no estadiamento. Conclusão: A PET/CT mostra-se como exame de potencial valor na rotina de avaliação de pacientes com câncer de cabeça e pescoço, entretanto, necessitamos de maior número de casos para definirmos protocolo de uso. Unitermos: Tomografia computadorizada de emissão; Fluordesoxiglicose F18; Neoplasias de cabeça e pescoço; Estadiamento de neoplasias; Carcinoma de células escamosas. AbstractResumo * Study developed in the

Alterações bucais em pacientes submetidos a tratamento para neoplasias malignas de cabeça e pescoço

“…The clinical staging of head and neck cancer and its location influence the therapeutic approach, and in most cases, surgical resection is the first choice of treatment. 15 In the present research, most patients were treated by the combination of RT and CT, agreeing with one study, 14 but differing from another, 7 which had the surgery associated with RT the most used form of treatment. This may be explained by the fact that the majority of patients treated at the Caruaru Oncology Center had the locally advanced disease unresectable, and combined treatment are recommended for these cases.…”

E quando a TC e a RM não oferecem acurácia suficiente?: a promissora contribuição da PET-CT na avaliação de pacientes com lesões malignas de cabeça e pescoço

“…In a retrospective study, Curioni et al (1) have included several small groups of patients with different histologic types of tumors, for which PET-CT demonstrated to be of great value, in agreement with the current literature, leading to changes in the therapeutic approach as the following parameters are considered: evaluation of regional lymph nodes involvement, presence of distant metastasis, occult primary site, presence of synchronous tumor, therapeutic response, presence of residual disease and recurrence. In all such situations, FDG PET-CT has contributed to a higher accuracy in the detection of lesions, however still at the expense of false-positive and false-negative results.…”

“…In the audience comprising Brazilian and French attendees, there was not a single physician who practiced the method. Such small niche of people seems to reflect a wider reality, pointed out in the article published by Curioni et al (1) , in the present issue of Radiologia Brasileira: the utilization of the method is restricted to few centers and is not yet included in routine protocols of imaging staging. Such a fact makes studies on PET-CT essential, and even urgent, as the technology progresses faster than the human capability of scientific validation of the diagnostic tool.…”