Abstract Archives of the RSNA, 2014
Luke Ienari Sonoda PhD, FRCR, Abstract Co-Author: Nothing to Disclose
Subhadip Ghosh-Ray MBBS, Presenter: Nothing to Disclose
Korinna-Zoi Karamagkioli, Abstract Co-Author: Nothing to Disclose
Wendy Sookram, Abstract Co-Author: Nothing to Disclose
Damion Melsome, Abstract Co-Author: Nothing to Disclose
18F-FDG PET-CT has been playing a significant role in the management of head and neck (H&N) malignancies. There have been recent suggestions that half-body (above diaphragm) PET-CT may be sufficient for the management of H&N cancer patients. This study aims to determine if half-body PET-CT is a safe practice option, or should we stick to whole-body PET-CT.
A 6-year-period (2008–2013) retrospective analysis of 729 consecutive PET-CT scans of H&N cancer patients was performed in order to record the incidence of below-diaphragm metastases and below-diaphragm synchronous primary malignancies. The four main indications of PET-CT in H&N cancers are; pre-treatment staging of high-risk of disseminated disease, metastatic cervical lymphadenopathy with unknown primary, assessment of therapeutic response and detection of recurrence/relapse.
A total of 664 Squamous Cell Carcinoma (SCC) and 65 Nasopharyngeal Carcinoma (NPC) cases were studied. 35/729 (4.8%) cases showed below-diaphragm metastases (liver, renal, adrenal, retroperitoneal and lumbar vertebral metastases), 24 out of 664 (3.3%) by SCC and 11 out of 65 (16.9%) by NPC.
52/729 (7.1%) cases showed synchronous primary malignancies, of which 32 (4.4%) were below-diaphragm (colonic, pancreatic, bladder cancers and retroperitoneal lymphoma).
In total, 84/729 (11.5%) H&N cases had either below-diaphragm metastases or below-diaphragm synchronous primary malignancies.
A significant proportion of H&N patients, over 10%, have either below-diaphragm metastases or below-diaphragm synchronous primary malignancies. Half-body (above diaphragm) PET-CT would have missed these lesions, leading to mis-staging of disease and mis-management of patients. It is important to keep whole-body PET-CT in practice in the management of H&N cancers. This is more so in the management of NPC compared to SCC.
It is essential to perform whole-body PET-CT in the management of H&N Cancers. Recently suggested half-body scan misses a significant proportion of below-diaphragm metastases and synchronous cancers.
Should We Perform Half-body or Whole-body 18F-FDG PET-CT in the Management of Head and Neck Cancers?. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000231.html