FDG-PET/CT in cancers of the head and neck

What is the definition of whole body scanning?

Andrei Iagaru, Erik Mittra, Sanjiv Sam Gambhir

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: The role of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) was studied in a variety of cancers, including head and neck squamous cell carcinomas (HNSCC) and nasopharyngeal carcinomas (NPC), with several presentations indicating that for these clinical entities a "whole-body" (i.e., eyes to thighs) may yield little additional information. Therefore, we were prompted to review our experience with PET/computed tomography (CT) in the management of patients with HNSCC and NPC. Materials and Methods: This is a retrospective study of 133 patients with HNSCC, 23-90 years old (average: 58.2±12.7) and 26 patients with NPC, ages 16-75 (average: 47.3±17.1), who had whole body PET/CT at our institution from Jan 2003 to Nov 2006. Reinterpretation of the imaging studies for accuracy and data analysis from medical records was performed. Lesions identified on PET/CT below the level of the adrenal glands were recorded and tabulated. Results: Lesions were identified below the adrenal glands in seven patients (5.2%) with HNSCC. These included hepatic and osseous metastases from HNSCC in two patients (1.5%), a new renal cancer (0.75%), a new pancreatic cancer (0.75%), a new colon cancer (0.75%) and findings proven benign on follow-up (focal colon uptake in one patient and an inflammatory inguinal lymph node in another patient; 1.5%). Lesions were identified below the adrenal glands in three patients (11.5%) with NPC. These included osseous metastases from NPC in two patients (7.7%) and findings proven benign on follow-up (focal colon uptake in one patient; 3.84%). Conclusion: This study suggests that whole body PET/CT imaging in HNSCC has a relatively low yield (3%, 95% CI: 1.33-8.42) of significant findings below the level of the adrenal glands. Therefore, implementing a more limited protocol (through the level of adrenal glands), especially in low-risk cases of HNSCC, may be considered. However, whole body PET/CT imaging in NPC may have a significant yield (7.7%, 95% CI: 1.02-25.26) of medically relevant findings below the level of the adrenal glands. Thus, the whole body (i.e., vertex to thighs) PET/CT scan of NPC patients appears to be the appropriate imaging protocol for this population. This recommendation requires further evaluation and validation in larger prospective studies.

Original languageEnglish (US)
Pages (from-to)362-367
Number of pages6
JournalMolecular Imaging and Biology
Volume13
Issue number2
DOIs
StatePublished - Apr 1 2011
Externally publishedYes

Fingerprint

Whole Body Imaging
Head and Neck Neoplasms
Glucose
Adrenal Glands
Tomography
Thigh
Colon
Positron Emission Tomography Computed Tomography
Neoplasm Metastasis
Groin
Kidney Neoplasms
Carcinoma, squamous cell of head and neck
Nasopharyngeal carcinoma
Pancreatic Neoplasms
Positron-Emission Tomography
Colonic Neoplasms
Medical Records
Retrospective Studies
Lymph Nodes

Keywords

  • Cancer
  • CT
  • FDG
  • Head and neck
  • PET

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

FDG-PET/CT in cancers of the head and neck : What is the definition of whole body scanning? / Iagaru, Andrei; Mittra, Erik; Gambhir, Sanjiv Sam.

In: Molecular Imaging and Biology, Vol. 13, No. 2, 01.04.2011, p. 362-367.

Research output: Contribution to journalArticle

@article{2890091fda1a403c83d460db9d253774,
title = "FDG-PET/CT in cancers of the head and neck: What is the definition of whole body scanning?",
abstract = "Purpose: The role of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) was studied in a variety of cancers, including head and neck squamous cell carcinomas (HNSCC) and nasopharyngeal carcinomas (NPC), with several presentations indicating that for these clinical entities a {"}whole-body{"} (i.e., eyes to thighs) may yield little additional information. Therefore, we were prompted to review our experience with PET/computed tomography (CT) in the management of patients with HNSCC and NPC. Materials and Methods: This is a retrospective study of 133 patients with HNSCC, 23-90 years old (average: 58.2±12.7) and 26 patients with NPC, ages 16-75 (average: 47.3±17.1), who had whole body PET/CT at our institution from Jan 2003 to Nov 2006. Reinterpretation of the imaging studies for accuracy and data analysis from medical records was performed. Lesions identified on PET/CT below the level of the adrenal glands were recorded and tabulated. Results: Lesions were identified below the adrenal glands in seven patients (5.2{\%}) with HNSCC. These included hepatic and osseous metastases from HNSCC in two patients (1.5{\%}), a new renal cancer (0.75{\%}), a new pancreatic cancer (0.75{\%}), a new colon cancer (0.75{\%}) and findings proven benign on follow-up (focal colon uptake in one patient and an inflammatory inguinal lymph node in another patient; 1.5{\%}). Lesions were identified below the adrenal glands in three patients (11.5{\%}) with NPC. These included osseous metastases from NPC in two patients (7.7{\%}) and findings proven benign on follow-up (focal colon uptake in one patient; 3.84{\%}). Conclusion: This study suggests that whole body PET/CT imaging in HNSCC has a relatively low yield (3{\%}, 95{\%} CI: 1.33-8.42) of significant findings below the level of the adrenal glands. Therefore, implementing a more limited protocol (through the level of adrenal glands), especially in low-risk cases of HNSCC, may be considered. However, whole body PET/CT imaging in NPC may have a significant yield (7.7{\%}, 95{\%} CI: 1.02-25.26) of medically relevant findings below the level of the adrenal glands. Thus, the whole body (i.e., vertex to thighs) PET/CT scan of NPC patients appears to be the appropriate imaging protocol for this population. This recommendation requires further evaluation and validation in larger prospective studies.",
keywords = "Cancer, CT, FDG, Head and neck, PET",
author = "Andrei Iagaru and Erik Mittra and Gambhir, {Sanjiv Sam}",
year = "2011",
month = "4",
day = "1",
doi = "10.1007/s11307-010-0343-8",
language = "English (US)",
volume = "13",
pages = "362--367",
journal = "Molecular Imaging and Biology",
issn = "1536-1632",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - FDG-PET/CT in cancers of the head and neck

T2 - What is the definition of whole body scanning?

AU - Iagaru, Andrei

AU - Mittra, Erik

AU - Gambhir, Sanjiv Sam

PY - 2011/4/1

Y1 - 2011/4/1

N2 - Purpose: The role of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) was studied in a variety of cancers, including head and neck squamous cell carcinomas (HNSCC) and nasopharyngeal carcinomas (NPC), with several presentations indicating that for these clinical entities a "whole-body" (i.e., eyes to thighs) may yield little additional information. Therefore, we were prompted to review our experience with PET/computed tomography (CT) in the management of patients with HNSCC and NPC. Materials and Methods: This is a retrospective study of 133 patients with HNSCC, 23-90 years old (average: 58.2±12.7) and 26 patients with NPC, ages 16-75 (average: 47.3±17.1), who had whole body PET/CT at our institution from Jan 2003 to Nov 2006. Reinterpretation of the imaging studies for accuracy and data analysis from medical records was performed. Lesions identified on PET/CT below the level of the adrenal glands were recorded and tabulated. Results: Lesions were identified below the adrenal glands in seven patients (5.2%) with HNSCC. These included hepatic and osseous metastases from HNSCC in two patients (1.5%), a new renal cancer (0.75%), a new pancreatic cancer (0.75%), a new colon cancer (0.75%) and findings proven benign on follow-up (focal colon uptake in one patient and an inflammatory inguinal lymph node in another patient; 1.5%). Lesions were identified below the adrenal glands in three patients (11.5%) with NPC. These included osseous metastases from NPC in two patients (7.7%) and findings proven benign on follow-up (focal colon uptake in one patient; 3.84%). Conclusion: This study suggests that whole body PET/CT imaging in HNSCC has a relatively low yield (3%, 95% CI: 1.33-8.42) of significant findings below the level of the adrenal glands. Therefore, implementing a more limited protocol (through the level of adrenal glands), especially in low-risk cases of HNSCC, may be considered. However, whole body PET/CT imaging in NPC may have a significant yield (7.7%, 95% CI: 1.02-25.26) of medically relevant findings below the level of the adrenal glands. Thus, the whole body (i.e., vertex to thighs) PET/CT scan of NPC patients appears to be the appropriate imaging protocol for this population. This recommendation requires further evaluation and validation in larger prospective studies.

AB - Purpose: The role of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) was studied in a variety of cancers, including head and neck squamous cell carcinomas (HNSCC) and nasopharyngeal carcinomas (NPC), with several presentations indicating that for these clinical entities a "whole-body" (i.e., eyes to thighs) may yield little additional information. Therefore, we were prompted to review our experience with PET/computed tomography (CT) in the management of patients with HNSCC and NPC. Materials and Methods: This is a retrospective study of 133 patients with HNSCC, 23-90 years old (average: 58.2±12.7) and 26 patients with NPC, ages 16-75 (average: 47.3±17.1), who had whole body PET/CT at our institution from Jan 2003 to Nov 2006. Reinterpretation of the imaging studies for accuracy and data analysis from medical records was performed. Lesions identified on PET/CT below the level of the adrenal glands were recorded and tabulated. Results: Lesions were identified below the adrenal glands in seven patients (5.2%) with HNSCC. These included hepatic and osseous metastases from HNSCC in two patients (1.5%), a new renal cancer (0.75%), a new pancreatic cancer (0.75%), a new colon cancer (0.75%) and findings proven benign on follow-up (focal colon uptake in one patient and an inflammatory inguinal lymph node in another patient; 1.5%). Lesions were identified below the adrenal glands in three patients (11.5%) with NPC. These included osseous metastases from NPC in two patients (7.7%) and findings proven benign on follow-up (focal colon uptake in one patient; 3.84%). Conclusion: This study suggests that whole body PET/CT imaging in HNSCC has a relatively low yield (3%, 95% CI: 1.33-8.42) of significant findings below the level of the adrenal glands. Therefore, implementing a more limited protocol (through the level of adrenal glands), especially in low-risk cases of HNSCC, may be considered. However, whole body PET/CT imaging in NPC may have a significant yield (7.7%, 95% CI: 1.02-25.26) of medically relevant findings below the level of the adrenal glands. Thus, the whole body (i.e., vertex to thighs) PET/CT scan of NPC patients appears to be the appropriate imaging protocol for this population. This recommendation requires further evaluation and validation in larger prospective studies.

KW - Cancer

KW - CT

KW - FDG

KW - Head and neck

KW - PET

UR - http://www.scopus.com/inward/record.url?scp=79955965422&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955965422&partnerID=8YFLogxK

U2 - 10.1007/s11307-010-0343-8

DO - 10.1007/s11307-010-0343-8

M3 - Article

VL - 13

SP - 362

EP - 367

JO - Molecular Imaging and Biology

JF - Molecular Imaging and Biology

SN - 1536-1632

IS - 2

ER -