title: Differentiating osteoradionecrosis from nasopharyngeal carcinoma tumour recurrence using ⁹⁹Tcm-sestamibi SPECT/CT.
abstract: Osteoradionecrosis (ORN) of the base of skull is a known complication of external beam radiotherapy in the treatment of nasopharyngeal carcinoma, and is widely believed to be sequelae of radiation-induced endarteritis, leading to cellular death and fibrosis. Differentiating ORN from tumour recurrence is challenging and has direct clinical implications. We present a case where (99)Tc(m)-sestamibi SPECT/CT was used to differentiate ORN from tumour recurrence and in which prior imaging using bone scintigraphy and fluorodeoxyglucose PET/CT were equivocal.
authors.affiliation: Department of Nuclear Medicine and PET, Singapore General Hospital, Singapore. andrew.tan@singhealth.com.sg
authors.forename: A E H
authors.initials: AE
authors.lastname: Tan
authors.forename: D C E
authors.initials: DC
authors.lastname: Ng
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D010025:Osteoradionecrosis / Q000000981:diagnostic imaging* / Q000473:pathology; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi