Whole-body (18)F-fluorodeoxyglucose positron emission tomography in patients with head and neck cancer.
OBJECTIVE
Because of the high risk of secondary primary malignancies in addition to possible distant metastases, whole-body evaluation is critically important in patients with head and neck cancer. We evaluated the clinical usefulness of whole-body (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) before initial treatment.


METHODS
We performed whole-body FDG PET in 26 patients with head and neck cancer (squamous cell carcinoma, n = 20; salivary gland carcinoma, n = 6) before initial treatment. FDG images were prospectively evaluated, and further imaging studies were performed if required. Final diagnosis for the presence or absence of distant lesions was made by analysis of the pathologic findings of surgical specimens or by analysis of the clinical follow-up data for more than 1 year.


RESULTS
PET images showed FDG avid lesions distant from the head and neck area in 3 of 26 patients (11.5%). Two patients were confirmed to have secondary primary cancer (one with colon cancer in the early stage and another with small lung metastasis from postoperative colon cancer). They were diagnosed and treated properly both for the head and neck cancer and the secondary primary cancer. One patient was confirmed to have large lung metastasis from head and neck cancer, and appropriate treatment was selected.


CONCLUSIONS
Whole-body FDG PET has a clinical impact on the management of patients with head and neck cancer by detecting secondary primary malignancies as well as distant metastases.
Kitagawa
Yoshimasa
Y
Department of Dentistry and Oral Surgery, Fukui Medical University, Matsuoka, Japan. ykitagaw@fmsra.fukui-med.jp
Nishizawa
Sadahiko
S
Sano
Kazuo
K
Sadato
Norihiro
N
Maruta
Yoshihiro
Y
Ogasawara
Toshiyuki
T
Nakamura
Mikiko
M
Yonekura
Yoshiharu
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging*; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18