F-18 FDG PET-CT fusion in radiotherapy treatment planning for head and neck cancer.
BACKGROUND
The fusion of fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) with CT scans has been shown to improve diagnostic accuracy and staging in non-small cell lung cancer. We report on the influence of PET-CT fusion on the management of patients with head and neck cancer.


METHODS
Thirty-six patients with intact primary head and neck cancers treated with radiation therapy (RT) received PET-CT as part of treatment planning. Workup before PET-CT included a contrast-enhanced CT scan of the head and neck and chest X-ray; patients with nasopharyngeal and paranasal sinus primary tumors also underwent MRI.


RESULTS
Changes in TNM score and American Joint Committee on Cancer stage occurred in 13 patients (36%) and five patients (14%), respectively, based on PET-CT. RT volume and dose were altered in five patients (14%) and four patients (11%), respectively. Five patients initially were seen with carcinoma of unknown primary, and PET-CT confirmed oropharyngeal primary tumors in two. PET-CT data also detected a synchronous lung cancer in one patient.


CONCLUSIONS
PET-CT fusion may have a significant impact on staging and determination of RT treatment volume and dose.
Koshy
Mary
M
Department of Radiation Oncology, Division of Nuclear Medicine and Molecular Imaging, Emory Clinic and Emory University, Atlanta, Georgia, USA.
Paulino
Arnold C
AC
Howell
Rebecca
R
Schuster
David
D
Halkar
Raghuveer
R
Davis
Lawrence W
LW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18