title: Application of positron emission tomography/computed tomography in radiation treatment planning for head and neck cancers.
abstract: 18-fluorodeoxygluocose positron emission tomography/computed tomography ((18)FDG-PET/CT) provides significant information in multiple settings in the management of head and neck cancers (HNC). This article seeks to define the additional benefit of PET/CT as related to radiation treatment planning for squamous cell carcinomas (SCCs) of the head and neck through a review of relevant literature. By helping further define both primary and nodal volumes, radiation treatment planning can be improved using PET/CT. Special attention is paid to the independent benefit of PET/CT in targeting mucosal primaries as well as in detecting nodal metastases. The utility of PET/CT is also explored for treatment planning in the setting of SCC of unknown primary as PET/CT may help define a mucosal target volume by guiding biopsies for examination under anesthesia thus changing the treatment paradigm and limiting the extent of therapy. Implications of the use of PET/CT for proper target delineation in patients with artifact from dental procedures are discussed and the impact of dental artifact on CT-based PET attenuation correction is assessed. Finally, comment is made upon the role of PET/CT in the high-risk post-operative setting, particularly in the context of radiation dose escalation. Real case examples are used in these settings to elucidate the practical benefits of PET/CT as related to radiation treatment planning in HNCs.
authors.affiliation: Musaddiq J Awan, Jiankui Yuan, Mitchell Machtay, Min Yao, Department of Radiation Oncology, Case Comprehensive Cancer Center, University Hospitals and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
authors.forename: Musaddiq J
authors.initials: MJ
authors.lastname: Awan
authors.affiliation: Musaddiq J Awan, Jiankui Yuan, Mitchell Machtay, Min Yao, Department of Radiation Oncology, Case Comprehensive Cancer Center, University Hospitals and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
authors.forename: Farzan
authors.initials: F
authors.lastname: Siddiqui
authors.affiliation: Musaddiq J Awan, Jiankui Yuan, Mitchell Machtay, Min Yao, Department of Radiation Oncology, Case Comprehensive Cancer Center, University Hospitals and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
authors.forename: David
authors.initials: D
authors.lastname: Schwartz
authors.affiliation: Musaddiq J Awan, Jiankui Yuan, Mitchell Machtay, Min Yao, Department of Radiation Oncology, Case Comprehensive Cancer Center, University Hospitals and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
authors.forename: Jiankui
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Musaddiq J Awan, Jiankui Yuan, Mitchell Machtay, Min Yao, Department of Radiation Oncology, Case Comprehensive Cancer Center, University Hospitals and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Machtay
authors.affiliation: Musaddiq J Awan, Jiankui Yuan, Mitchell Machtay, Min Yao, Department of Radiation Oncology, Case Comprehensive Cancer Center, University Hospitals and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
authors.forename: Min
authors.initials: M
authors.lastname: Yao
keywords: Computed tomography; Fluorodeoxygluocose positron emission tomography; Head and neck cancer; Imaging; Radiation treatment planning