Use of FDG PET for Staging and Re-Staging of Head and Neck Squamous Cell Carcinoma

TL;DR

FDG PET/CT improves staging and treatment planning for head and neck cancers compared to traditional imaging.

Contribution

FDG PET/CT is shown to detect hidden tumors and guide treatment changes more effectively than conventional methods.

Findings

FDG PET/CT detects nodal and distant metastases better than conventional imaging.

PET/CT identifies occult primary tumors and synchronous malignancies.

PET/CT results influence surgical and chemoradiation treatment plans.

Abstract

18F-FDG PET/CT plays a complementary role to clinical evaluation in the staging, treatment planning, treatment response assessment, recurrent disease detection, and follow-up of patients with head and neck cancer. It plays both a complementary and advantageous role over conventional imaging techniques, providing an added advantage in the detection of synchronous and occult primary tumors, improving staging, and impacting treatment strategies, including surgical, radiation, and systemic treatment. It provides valuable prognostic information at different stages of diagnosis, treatment, and follow-up. The role of PET/CT in these cancers is constantly evolving, with ongoing and future trials discovering new and valuable information which can have a significant impact on the future management of these cancers.

Head and neck cancers account for approximately 3.0% of all new cancer diagnoses. 18F-FDG PET/CT plays an important role in the initial staging of these cancers, especially in the detection of nodal and distant metastatic disease, outperforming conventional imaging techniques. It helps identify occult primary tumors and synchronous second primary malignancies. PET/CT findings can lead to treatment plan alterations both in surgical and primary or adjuvant chemoradiation plans. High negative predictive value at treatment response assessment provides valuable prognostic implications. PET/CT can predict outcomes at baseline and during or after treatment.

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