Staging of head and neck squamous cell cancer with extended-field FDG-PET.

Abstract

BACKGROUND:

Accurate baseline staging is necessary to appropriately treat head and neck squamous cell carcinoma. [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) is valuable for locoregional staging of primary head and neck disease. The effectiveness of FDG-PET for the detection of distant metastatic or synchronous disease remains unproven.

OBJECTIVE:

To investigate the utility of FDG-PET extended into the abdomen (extended-field FDG-PET) for wide-field staging of head and neck tumors.

METHODS:

This is a prospective institutional study of 35 consecutive patients diagnosed with American Joint Committee on Cancer (AJCC)-defined stage II-IV squamous cell carcinoma of the oral cavity, oropharynx, or larynx between September 2000 and June 2002. Thirty-three patients (94%) were eligible for analysis. All patients were routinely staged with chest radiography, liver function tests, and extended-field FDG-PET. Chest or abdominal computed tomographic scans were used as corroborative studies and were obtained only when one of the above tests indicated distant disease.

RESULTS:

Of 33 patients, 7 (21%) had evidence of distant disease by extend-field FDG-PET-4 with metastases and 3 with synchronous primary cancers of the aerodigestive tract. [F-18]-fluorodeoxyglucose PET detected hepatic, bone, gastrointestinal, and mediastinal disease not identified by chest radiography or liver function tests. Two of the 7 patients with FDG-avid distant disease had false-negative staging by all other tests, including computed tomography.

CONCLUSIONS:

Extended-field FDG-PET is feasible and may improve staging of primary head and neck squamous cell carcinoma. Use of staging FDG-PET must be explicitly described in reports from centers engaged in prospective research to facilitate comparison with historical results.

• Authors: David L Schwartz, Joseph Rajendran, Bevan Yueh, Marc Coltrera, Yoshimi Anzai, Kenneth Krohn, Janet Eary
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 129 Issue 11 Pg. 1173-8 (Nov 2003) ISSN: 0886-4470 [Print] United States
• PMID: 14623746 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Carcinoma, Squamous Cell (diagnostic imaging, pathology, secondary)
• Digestive System Neoplasms (diagnostic imaging, secondary)
• Feasibility Studies
• Fluorodeoxyglucose F18
• Head and Neck Neoplasms (diagnostic imaging, pathology)
• Humans
• Neoplasm Staging
• Neoplasms, Multiple Primary (diagnostic imaging)
• Prospective Studies
• Radiopharmaceuticals
• Tomography, Emission-Computed