FDG positron emission tomography in head and neck cancer - Pitfall or pathology?

Purpose: Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a f unctional imaging technique used for imaging and staging malignant diseases . In many oncologic situations, however, abnormal changes seen an the PET s tudies are not caused by tumor, which is especially true in the head and ne ck region. The authors present an overview of the phenomena that may confou nd the interpretation of the images in head and neck cancer. Materials and Methods: FDG PET studies were performed in patients with prim ary head and neck cancer and in patients in whom recurrent disease was like ly. The results were correlated with clinical findings. Eight solitary case s were selected from a total of 180 patients studied. Results and Conclusions: Benign lesions and iatrogenic and physiologic chan ges may show increased FDG uptake. Therefore, clinical information on previ ous surgical interventions and optimal patient preparation are necessary fo r adequate interpretation. If these prerequisites can be met, benign lesion s appear to be the only lesions that may interfere with the specificity of FDG PET.