F-18 FDG PET-CT fusion in radiotherapy treatment planning for head and neck cancer

✍ Scribed by Mary Koshy; Arnold C. Paulino; Rebecca Howell; David Schuster; Raghuveer Halkar; Lawrence W. Davis

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 614 KB
• Volume: 27
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20179

✦ Synopsis

Background. The fusion of fluoro-2-deoxy-Dglucose -positron emission tomography (FDG-PET) with CT scans has been shown to improve diagnostic accuracy and staging in non-small cell lung cancer. We report on the influence of PET-CT fusion on the management of patients with head and neck cancer.

Methods. Thirty-six patients with intact primary head and neck cancers treated with radiation therapy (RT) received PET-CT as part of treatment planning. Workup before PET-CT included a contrast-enhanced CT scan of the head and neck and chest X-ray; patients with nasopharyngeal and paranasal sinus primary tumors also underwent MRI.

Results. Changes in TNM score and American Joint Committee on Cancer stage occurred in 13 patients (36%) and five patients (14%), respectively, based on PET-CT. RT volume and dose were altered in five patients (14%) and four patients (11%), respectively. Five patients initially were seen with carcinoma of unknown primary, and PET-CT confirmed oropharyngeal primary tumors in two. PET-CT data also detected a synchronous lung cancer in one patient.

Conclusion. PET-CT fusion may have a significant impact on staging and determination of RT treatment volume and dose.