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Fluorine-18 fluorodeoxyglucose imaging using dual-head coincidence positron emission tomography without attenuation correction in patients with head and neck cancer.

Pai, M; Park, CH; Suh, JH; Koh, JH
Clinical nuclear medicine, 24(7):495-500, 1999
Journal Title
Clinical nuclear medicine
PURPOSE: An accurate, preoperative assessment of tumor extent and lymph node involvement is necessary to plan and tailor therapy for patients with head and neck cancer. Metabolic imaging with fluorine-18 fluorodeoxy-glucose (FDG) is a good method to detect primary tumors in the head and neck and to assess the involvement of lymph nodes, but it is not widely available because of the high cost of positron emission tomography (PET). Recently, an alternative method for using FDG was developed: coincidence detection PET (CoDe PET) using a gamma camera. The aim of this study was to evaluate the clinical utility of FDG CoDe PET using a gamma camera in patients with head and neck cancer.

MATERIALS AND METHODS: Thirty FDG CoDe PET studies without attenuation correction were performed in seven patients before therapy and in 19 patients after therapy (ages: 25-79 years, mean, 50 +/- 13 years; 18 men, 8 women) with various head and neck cancers. All patients had fasted for 6 to 12 hours and were injected with 111 to 370 MBq F-18 FDG 1 hour before imaging. Visually detectable focal FDG uptake in the primary tumor site or in the neck was considered positive except for physiologic uptake. The FDG CoDe PET studies were correlated with MRI. The gold standard for the presence of disease was the combination of repeated MRIs, endoscopic examination, and 3 months of follow-up clinical evaluation.

RESULTS: FDG CoDe PET had a detection rate that was comparable to that of MRI in the pretherapy group. However, in the posttherapy group, FDG CoDe PET could differentiate residual tumor or tumor recurrence from radiation change more accurately than could MRI. However, it had a less accurate detection rate for cervical node metastases because of asymmetric neck muscle uptake.

CONCLUSIONS: FDG CoDe PET is a sensitive and cost-effective method to detect primary tumor and lymph node involvement in primary head and neck cancers. It is also useful in differentiating residual tumor or tumor recurrence from posttherapy changes in patients with head and neck tumors.
MeSH terms
AdultAgedFemaleFluorodeoxyglucose F18/diagnostic useFluorodeoxyglucose F18/pharmacokineticsGamma CamerasHead/radionuclide imagingHead and Neck Neoplasms/diagnosisHead and Neck Neoplasms/radionuclide imaging*Head and Neck Neoplasms/therapyHumansImage Processing, Computer-AssistedLymph Nodes/radionuclide imagingLymphatic Metastasis/radionuclide imaging*Magnetic Resonance ImagingMaleMiddle AgedNeck/radionuclide imagingNeoplasm Recurrence, Local/radionuclide imagingNeoplasm, Residual/radionuclide imagingRadiopharmaceuticals/diagnostic useRadiopharmaceuticals/pharmacokineticsSensitivity and SpecificityTomography, Emission-Computed/economicsTomography, Emission-Computed/instrumentationTomography, Emission-Computed/methods*
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Otolaryngology
Journal Papers > School of Medicine / Graduate School of Medicine > Nuclear Medicine & Molecular Imaging
AJOU Authors
박, 찬희서, 정호고, 중화
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