Positron Emission Tomography and Molecular Imaging of Head and Neck Malignancies
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NUCLEAR MEDICINE & PET/CT IMAGING (R FLAVELL, SECTION EDITOR)
Positron Emission Tomography and Molecular Imaging of Head and Neck Malignancies Farshad Moradi1
Accepted: 31 August 2020 Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Metabolic reprogramming and avid fluorodeoxyglucose (FDG) uptake in locally advanced head and neck squamous cell carcinomas and other cancers of the upper aerodigestive tract lead to favorable sensitivity and diagnostic accuracy of FDG PET/CT or PET/MR compared to conventional imaging. Meanwhile, the role of non-FDG PET in head and neck malignancies is rapidly expanding. Recent Findings Accurate staging, identifying a clinically occult primary, or detection of distant metastasis or a synchronous malignancy on FDG PET significantly impacts management. FDG uptake after definitive therapy is an invaluable biomarker for surveillance. Patients with metabolic resolution can be spared from neck dissection, whereas FDG avid refractory disease or distant metastasis could necessitate surgical or systemic therapy. PET tracers targeting amino acid transport or fibroblast activation hold promise for improved specificity and better delineation of tumor prior to radiation therapy given their low physiologic or inflammatory uptake in head and neck compared to FDG. Tracers for hypoxia or cellular proliferation provide complementary information to FDG after radiation therapy for assessment of residual malignant cells that could lead to treatment failure. FDG remains the primary tracer for imaging lymphoma and other pediatric head and neck malignancies. Several other PET tracers such as galliumThis article is part of the Topical collection on Nuclear Medicine & PET/CT Imaging. & Farshad Moradi [email protected] 1
Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, CA, USA
68-labeled somatostatin receptor analogs and fluorodopa are being increasingly used for detection and characterization of head and neck paragangliomas and certain other cancers. Summary FDG and other PET radiopharmaceuticals are increasingly being exploited in guiding clinical management of various head and neck malignancies and significantly impact patient outcomes. Keywords Head and neck neoplasms Positron emission tomography–computed tomography Squamous cell carcinoma of head and neck Therapy assessment (18) FDOPA (68)Ga-SSA
Introduction Head and neck cancers comprise a heterogenous group of malignancies with distinct histopathology, oncogenesis, clinical behavior, and prognosis. Cancers of the upper aerodigestive tract (nasal cavity and paranasal sinuses, lips and oral cavity, salivary glands, pharynx, and larynx) are significant causes of morbidity and cancer-associated mortality and are by far the most common group of head and neck malignancies referred for imaging. Lymphoma is the most common head and neck malignancy encountered in pediatric imaging centers. Other malignancies w
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