Detection of cancer recurrence in irradiated mandible using positron emission tomography.
Positron emission tomography (PET) is a promising method for pretherapeutic assessment of spread of squamous cell carcinomas (SCC) in the head and neck. A 41-year-old man with a history of operated and irradiated SCC of the tongue presented 4 years later with symptoms and signs of mandibular osteoradionecrosis. No changes related to malignancy could be seen in panoramic radiographs or computed tomography scanning with contrast enhancement. Since a biopsy of the involved region was positive for SCC, a PET study with [18F]fluorodeoxyglucose (FDG) was performed. In dynamic PET images, intensive uptake of FDG was seen in a small area close to the right mental foramen. A hemimandibulectomy with reconstruction using a free vascularized graft from iliac crest was performed. In the resected specimen, histological examination showed a 1.2-mm focus of SCC in the soft tissue and bone around the mental foramen. These findings indicate that FDG-PET might be useful for presurgical evaluation of cancer recurrence in a previously irradiated mandible, especially if PET can accurately differentiate viable tumor tissue from radiation-induced fibrosis and inflammation.
Minn
H
H
Department of Oncology, University of Turku, Finland.
Aitasalo
K
K
Happonen
R P
RP
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary*; D003847:Deoxyglucose / Q000031:analogs & derivatives; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000000981:diagnostic imaging; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D010025:Osteoradionecrosis / Q000000981:diagnostic imaging; D011859:Radiography; D014055:Tomography, Emission-Computed; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy*
D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose