Abstract
PurposeUse of 18-FDG PET–CT is increasing in patients with head and neck cancer, enabling the identification of metastases or synchronous malignancies, but also ‘incidental’ disease. We aimed to establish the rate of ‘incidental’ findings resulting from 18-FDG PET-specific imaging, that would not have been otherwise identified on other imaging, in patients with head and neck cancer undergoing staging or surveillance of disease.Methods18-FDG PET–CT was performed for investigation or surveillance. Case notes were reviewed retrospectively. Unexpected findings identifiable on CT imaging alone, or by FDG-PET were recorded. For those only identifiable with FDG-PET, findings were divided into either ‘incidental’ or ‘intentional’, and benign or malignant.Results93 patients underwent 18- FDG PET–CT. 86.0% had new pathology identified. 3.2% had a new malignancy identified. 37.6% had new findings on FDG-PET that would not have been identified on CT alone: 5.4% had ‘intentional findings’ (metastasis), and 32.3% had ‘incidental findings’ (synchronous malignancy or benign). 1.1% had a new malignancy on FDG-PET alone.ConclusionsIntentional and incidental findings are likely on 18-FDG PET–CT. Whilst important for patient management, there is an associated emotional and financial cost, which needs acknowledgement and further investigation.
Highlights
Head and neck cancer (HNC) affects 700,000 people worldwide and over 9000 in the UK [1]
NICE advocates 18-FDG PET–CT early in the diagnostic pathway for these patients [4]. In those patients treated with primary CRT, the recent study by Mehanna et al has shown that the results of 18-FDG PET–CT can be used to guide the management of the neck and avoid a neck dissection in many situations [5]
236 consecutive patient notes were reviewed, who presented to the head and neck cancer (HNC) clinic as above. 119 had undergone 18-FDG PET–CT and were, included in the study. 26 further patients were excluded as above, leaving 93 patients in the study
Summary
Head and neck cancer (HNC) affects 700,000 people worldwide and over 9000 in the UK [1]. The role of 18-fluorodeoxyglucose positron emission tomography–computed tomography (18-FDG PET–CT) has continued to increase, in part because the sensitivity and specificity for identifying the primary site and extent of nodal disease is improved compared to other forms of radiological investigation This is due to the combination of structural assessment using the CT component, alongside the metabolic component using the FDG tracer. NICE advocates 18-FDG PET–CT early in the diagnostic pathway for these patients [4] In those patients treated with primary CRT, the recent study by Mehanna et al has shown that the results of 18-FDG PET–CT can be used to guide the management of the neck and avoid a neck dissection in many situations [5]. This is advantageous both in terms of morbidity to the patient, and cost to the health service
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
