Value of 18F-FDG metabolic imaging in diagnosis and treatment of head and neck tumors and its mechanism study

Abstract

To study the value of (18)F-FDG dual-head tomography with coincidence (DHTC) and single photon emission computerized tomography (SPECT) coincidence imaging in diagnosis and treatment of head and neck tumors and mechanism thereof and analyze the value of glucose transporter proteins in the mechanism of increased uptake glucose of head and neck malignant tumor. Twenty-five patients with head and neck tumors were examined by CT or MRI and underwent (18)F-FDG DHTC and coincidence imaging. The results of these 2 different methods were compared. Fresh tissues of 38 patients with malignant tumors of the head-and-neck underwent RT-PCR and immunohistochemical examination. The sensitivity, specificity, and accuracy of (18)F-FDG coincidence imaging and registration with integrated CT (SPECT/CT) in diagnosis of the head and neck tumors was 100.0%, 87.5%, and 96.0% respectively, all significantly higher than those of the anatomical imaging (64.7%, 50.0%, and 60.0% respectively, all P < 0.05). For the lesions on the same site, SPECT/CT could diagnose exactly the primary tumor site of neck metastasis in four cases and diagnose the malignancy or benignancy of other four cases that anatomical imaging (CT/MRI) could not diagnose exactly. (18)F-FDG coincidence imaging and registration with integrated CT could find extra lesions of tumors. The results of RT-PCR and immunohistochemistry showed that the mRNA expression and protein expression of Glut-1 and Glut-3 were higher in the head and neck cancer than that in the normal tissue of head and neck or in the adjacent tissue (all P < 0.05). (18)F-FDG coincidence imaging and registration with integrated CT can be as a prospective tool that can judge the malignancy or benignancy of head and neck tumor, and stage and classify the tumor, and distinguish recurrence or necrosis of tumor after treatment by surgery or radiotherapy, and detect unknown primary tumor. The abnormal expressions of Glut-1 and Glut-3 may be correlated with the increased uptake of glucose of head and head cancer.