18F-FDG-PET/CT of orofacial tumors, a value of whole-body imaging approach

Ferda, Jiří; Ferdová, Eva; Záhlava, Jan; Walter, Jiří; Mukenšnabl, Petr; Daum, Ondřej; Kreuzberg, Boris

doi:10.1016/j.ejrad.2008.10.036

« Previous Next »European Journal of Radiology
Volume 73, Issue 2 , Pages 241-248, February 2010

¹⁸F-FDG-PET/CT of orofacial tumors, a value of whole-body imaging approach

Jiří Ferda
- Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
- Department of Radiology, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
- Corresponding author at: Department of Radiology, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic.
Eva Ferdová
- Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
- Department of Radiology, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
Jan Záhlava
- Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
Jiří Walter
- Department of Stomatosurgery, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
Petr Mukenšnabl
- šiklǐs Institute of Pathological Anatomy, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
Ondřej Daum
- šiklǐs Institute of Pathological Anatomy, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic
Boris Kreuzberg
- Department of Nuclear Medicine, University Hospital Plzen and Medical Faculty Plzen, Alej Svobody 80, 306 40 Plzeň, Czech Republic

Received 21 July 2008; received in revised form 28 September 2008; accepted 28 October 2008.

Abstract

Aim

Staging of head and neck tumors is one of the most difficult tasks in imaging techniques, due to the very complicated head and neck anatomy and serious problems with the differentiation of reactive enlarged lymph nodes and lymph nodes involved with metastases. The aim of the study was to evaluate the validity of the whole-body approach in the assessment of head and neck malignancies using ¹⁸F-FDG-PET/CT.

Materials and methods

The analysis of a group of 1750 consecutive whole-body procedures in all indications of ¹⁸F-FDG-PET/CT was made according to: the presence of orofacial tumors; their histology; findings concerning the spread outside head and neck region; and findings concerning the primary staging or restaging. The examinations of head and neck tumors were performed after intravenous application of the ¹⁸F-FDG and its accumulation for one hour. Drinking and speaking is restricted during this accumulation to prevent artificial muscle ¹⁸F-FDG uptake and to minimize false positive findings. In our hospital, high resolution PET is followed by the sub-millimeter isotropic acquisition of CT data after intravenous application of an iodinated contrast material. The acquisitions of head and neck region and trunk are performed separately to obtain optimal resolution in both regions.

Results

105 examinations of the orofacial tumors were performed on 87 patients in a group of 1750 consecutive PET/CT examinations. The ratio between primary staging and restaging was 3:7. The most frequent indications were carcinomas of the tongue (19 examinations) and carcinomas of the salivary glands (19 examinations). The metastatic spread of the tumor outside the region of the head and neck was noted in 12 cases.