PET SCANNING IN HEAD AND NECK ONCOLOGY - A REVIEW

Background. The objective of this study was to review and describe the usage of fluorine-labeled deoxyglucose (FDG) and positron emission to mography (PET) in the diagnosis and management of head and neck cancer . Methods. Several prospective series,-including 159 newly diagnosed a nd previously untreated and 23 previously irradiated head and neck squ amous cell carcinoma patients initially seen at the Wake Forest Univer sity Medical Center and evaluated by clinical examination, conventiona l computed tomography/ magnetic resonance imaging (CT/MRI) scans, PET scans, and histopathologic studies,-were reviewed and the findings sum marized for comparison of the correct differentiation of primary and m etastatic cancers and for postirradiation tumor clearance in a subsegm ent of those cases. Results. Position emission tomography scanning usi ng a fluorine-labeled deoxyglucose (FDG) radiotracer proved as reliabl e as conventional scanning for primary and metastatic tumor identifica tion. Compared with clinical examination, PET was better for identific ation of nodal metastatic tumors but poorer for small primary tumors. For previously irradiated patients treated at least 4 months before th e test, PET scanning was clearly superior to clinical examination and conventional imaging in differentiating tumor recurrence from soft-tis sue irradiation effects. Conclusions. Fluorine-labeled deoxyglucose-PE T scanning is comparable to conventional imaging of head and neck canc ers in detecting primary and metastatic carcinoma. Lack of anatomic de tail remains its major drawback. Currently. its greatest role is in th e evaluation of the postradiotherapy patient. (C) 1998 John Wiley & So ns. Inc.