VALIDATION AND CLINICAL-APPLICATION OF COMPUTER COMBINED COMPUTED-TOMOGRAPHY AND POSITRON EMISSION TOMOGRAPHY WITH 2-[18F]FLUORO-2-DEOXY-D-GLUCOSE HEAD AND NECK IMAGES

BACKGROUND: Positron emission tomography with 2-[18F]fluoro-2-deoxy-D- glucose (PET-FDG) improves the detection of head and neck squamous cel l cancer (HNSCC), but lacks anatomical detail. The accuracy of registe red computed tomography/magnetic resonance (CT/MR) and PET-FDG in deli neation of HNSCC at the primary site and its clinical application was investigated. METHOD: Preoperatively 30 patients were staged clinicall y and each had either CT (23), MR (5), or both CT and MR (2) scans, as well as CT/MR-PET-FDG registration, Turner margins or infiltration of specific anatomical landmarks on the different scans were compared an d judged against histology. RESULTS: For primary turners CT-PET-FDG (9 7%) and MR-PET-FDG (100%) delineated the tumor more accurately than CT (69%) or MR (40%) alone, Similarly, CT-PET-FDG (98%) and MR-PET-FDG ( 100%) were better than CT (70%) and MR alone (80%) in identifying tumo r invasion of specific anatomical structures. Management was altered i n 7 of 30 patients, The registered images were particularly useful in delineating tumor extension in the infratemporal fossa, maxilla and ma ndible, and identifying recurrences obscured by scar tissue. CONCLUSIO NS: It is possible to accurately register CT, MR, and PET-FDG data set s in the head and neck, The initial results show that registered CT/MR -PET-FDG images provide additional clinically relevant information ove r that obtained from clinical evaluation or conventional CT/MR imaging . (C) 1996 by Excerpta Medica, Inc.