Virtual 3-D ¹⁸F-FDG PET/CT panendoscopy for assessment of the upper airways of head and neck cancer patients: a feasibility study.
OBJECTIVE
The aim of this study was to evaluate whether a virtual 3-D (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT panendoscopy is feasible and can be used for noninvasive imaging of the upper airways and pharyngeal/laryngeal tumours.


METHODS
From (18)F-FDG PET/CT data sets of 40 patients (29 men, 11 women; age 61 ± 9 years) with pharyngeal or laryngeal malignancies virtual 3-D (18)F-FDG PET/CT panendoscopies were reconstructed and the image processing time was measured. The feasibility of assessing the oral cavity, nasopharynx, tongue base, soft palate, pharyngeal tonsils, epiglottis, aryepiglottic folds, piriform sinus, postcricoid space, glottis, subglottis, trachea, bronchi and oesophagus and of detecting primary tumours was tested. Results of fibre-optic bronchoscopy and histology served as the reference standard.


RESULTS
The nasopharynx, tongue base, soft palate, pharyngeal tonsils, epiglottis, subglottis and the tracheobronchial tree were accessible in all 40, and the aryepiglottic folds, posterior hypopharyngeal wall, postcricoid space, piriform sinus, glottis, oral cavity and oesophagus in 37, 37, 37, 37, 33, 16 and 0 patients, respectively. In all 12 patients with restricted fibre-optic evaluation due to being primarily intubated, the subglottis was accessible via virtual panendoscopy. The primary tumour was depicted in 36 of 40 patients (90 %). The mean processing time for virtual (18)F-FDG PET/CT panendoscopies was 145 ± 98 s.


CONCLUSIONS
Virtual (18)F-FDG PET/CT panendoscopy of the upper airways is technically feasible and can detect pharyngeal and laryngeal malignancies. This new tool can aid in the complete evaluation of the subglottic space in intubated patients and may be used for planning optical panendoscopies, biopsies and surgery in the future.
Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
Christian
C
Buchbender
Jon
J
Treffert
Götz
G
Lehnerdt
Stefan
S
Mattheis
Bernhard
B
Geiger
Andreas
A
Bockisch
Michael
M
Forsting
Gerald
G
Antoch
Till A
TA
Heusner
D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010610:Pharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography; D012137:Respiratory System / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
D019788:Fluorodeoxyglucose F18