title: (18)F-FDG PET/CT quantification in head and neck squamous cell cancer: principles, technical issues and clinical applications.
abstract: (18)F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. (18)F-FDG PET/CT is also used for precise delineation of the tumour volume for radiation therapy planning and dose painting, and for treatment response monitoring, by detecting residual or recurrent disease. Most of these applications would benefit from a quantitative approach to the disease, but the quantitative capability of (18)F-FDG PET/CT is still underused in HNSCC. Innovations in PET/CT technology promise to overcome the issues that until now have hindered the employment of dynamic procedures in clinical practice and have limited "quantification" to the evaluation of standardized uptake values (SUV), de facto a semiquantitative parameter, the limits of which are well known to the nuclear medicine community. In this paper the principles of quantitative imaging and the related technical issues are reviewed so that professionals involved in HNSCC management can reflect on the advantages of "true" quantification. A discussion is then presented on how semiquantitative information is currently used in clinical (18)F-FDG PET/CT applications in HNSCC, by discussing the improvements that could be obtained with more advanced and "personalized" quantification techniques.
authors.affiliation: Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Manca
authors.affiliation: Service of Medical Physics, University Hospital of Siena, Viale Bracci 16, Siena, 53100, Italy. eleonora.vanzi@ao-siena.toscana.it.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Vanzi
authors.affiliation: Department of Nuclear Medicine, Santa Maria della Misericordia Rovigo Hospital, Via Tre Martiri 140, 45100, Rovigo, Italy. domenico.rubello@libero.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.affiliation: Médecine Nucléaire, Centre Hospitalier and Biophysique, Faculté Charles Mérieux, Lyon, France.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giammarile
authors.affiliation: Department of Nuclear Medicine, Santa Maria della Misericordia Rovigo Hospital, Via Tre Martiri 140, 45100, Rovigo, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Grassetto
authors.affiliation: Nuclear Medicine/Radiology Department, University of Michigan Hospital, Ann Arbor, MI, USA.|Department of Veterans Affairs Health System, Nuclear Medicine Service, Ann Arbor, MI, USA.
authors.forename: Ka Kit
authors.initials: KK
authors.lastname: Wong
authors.affiliation: Department of Radiological Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Perkins
authors.affiliation: Department of Radiology, Southern University of California, Los Angeles, CA, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Colletti
authors.affiliation: Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy.
authors.forename: Duccio
authors.initials: D
authors.lastname: Volterrani
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D006801:Humans; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG PET/CT quantification; Head and Neck cancer