FDG positron emission tomography in head and neck cancer: pitfall or pathology?
OBJECTIVE
Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a functional imaging technique used for imaging and staging malignant diseases. In many oncologic situations, however, abnormal changes seen on the PET studies are not caused by tumor, which is especially true in the head and neck region. The authors present an overview of the phenomena that may confound the interpretation of the images in head and neck cancer.


METHODS
FDG PET studies were performed in patients with primary head and neck cancer and in patients in whom recurrent disease was likely. The results were correlated with clinical findings. Eight solitary cases were selected from a total of 180 patients studied.


CONCLUSIONS
Benign lesions and iatrogenic and physiologic changes may show increased FDG uptake. Therefore, clinical information on previous surgical interventions and optimal patient preparation are necessary for adequate interpretation. If these prerequisites can be met, benign lesions appear to be the only lesions that may interfere with the specificity of FDG PET.
Stokkel
M P
MP
Department of Nuclear Medicine, University Hospital Utrecht, The Netherlands.
Bongers
V
V
Hordijk
G J
GJ
van Rijk
P P
PP
D000328:Adult; D000368:Aged; D016477:Artifacts; D001786:Blood Glucose / Q000032:analysis; D003937:Diagnosis, Differential; D005215:Fasting; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007049:Iatrogenic Disease; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D010212:Papilloma / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014945:Wound Healing
D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18