title: The role of gamma-PET in the evaluation of patients with recurrent squamous cell cancer of the head and neck.
abstract: Squamous cell carcinoma (SCC) is the most common cancer of the head and neck (HNC). Advanced HNC warrants extensive ablative and reconstructive procedures, significantly altering locoregional anatomy, while radiation treatment further adds to the distortion. Anatomic imaging is therefore often inconclusive in suspected recurrent HNC. Functional imaging with fluorodeoxyglucose-positron emission tomography (FDG-PET) has been reported contributory in the evaluation of patients with SCC. While most reports are from dedicated PET systems, full ring PET is of limited availability and gamma-PET may offer a suitable compromise. The therapeutic impact of gamma-PET in patients with suspected recurrent HNC was retrospectively evaluated. Seventeen patients were evaluated. All had undergone surgery for HNC, 16 also received radiotherapy. gamma-PET scans were compared to anatomic imaging, histopathology and clinical follow-up. The impact of the FDG-PET scan on patient management was then evaluated. Eleven positive findings were confirmed. Two false positives were due to radiation changes, a recognized pitfall. There were no false negatives. Overall accuracy of the 18F-FDG gamma-PET scans was 88% with considerable effect on patient management. Gamma-PET with FDG appears valuable in the evaluation of suspected recurrent HNC, and may provide a suitable alternative when dedicated PET is unavailable.
authors.affiliation: Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv 52621, Israel. egoshen@sheba.health.gov.il
authors.forename: E
authors.initials: E
authors.lastname: Goshen
authors.forename: R
authors.initials: R
authors.lastname: Yahalom
authors.forename: Y P
authors.initials: YP
authors.lastname: Talmi
authors.forename: G
authors.initials: G
authors.lastname: Rotenberg
authors.forename: Y
authors.initials: Y
authors.lastname: Oksman
authors.forename: S T
authors.initials: ST
authors.lastname: Zwas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18