Utilization of PET/CT Scan in Head and Neck Carcinoma: A Tertiary Care Hospital Experience
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ORIGINAL ARTICLE
Utilization of PET/CT Scan in Head and Neck Carcinoma: A Tertiary Care Hospital Experience Rajeev Chugh1 • D. K. Gupta1 Rekha Vashisth3 • Sunil Goyal1
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Bhaumik Patel1 • Arun Ravi John2
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Received: 29 August 2020 / Accepted: 14 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract Objective PET/CT scan has been increasingly used in assessment of Head and Neck cancer prior to treatment for evaluation and for surveillance. In this study we aim to assess the utilization of PET/CT scan at a tertiary care hospital. Methods Retrospectively data was reviewed of all patients of Head and Neck cancer who underwent PET/CT scan for workup or for follow-up between July 2018 and December 2019. PET/CT scan done in the pre-treatment assessment and post-treatment surveillance were analyzed for its utility. Results A total of 145 patients were included. The main indication for pre-treatment PET/CT scan was loco-regionally advanced disease (62 of 90 patients, 68.8%). No & Rajeev Chugh [email protected] D. K. Gupta [email protected] Bhaumik Patel [email protected] Arun Ravi John [email protected] Rekha Vashisth [email protected] Sunil Goyal [email protected] 1
ENT Department, Army Hospital Research and Referral, New Delhi 110010, India
2
Department of Nuclear Medicine, Army Hospital Research and Referral, New Delhi 110010, India
3
Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi 110010, India
specific indication was noted in 19 patients (21%). A significant change in treatment decision was seen in pretreatment patients based on M stage following a PET/CT scan. However, no change was noted on the basis of T or N stage. In the post-treatment surveillance there was a significant correlation of type of recurrence with clinical assessment and indication for PET/CT scan. 37 out of 87 patients (42.5%) underwent PET/CT scan for no specific reason, of which, 07 patients (18.9%) were detected to have distant metastasis. Conclusion Role of PET/CT in the pre-treatment assessment is very limited and maybe confined to advanced local or regional disease. Post-treatment surveillance with PET/ CT scan has a promising role and must be done as a baseline during 1st follow up at 03 months in all patients who have advanced disease and have undergone multimodality treatment for the same. Keywords PET/CT Head and neck cancer Post-treatment surveillance
Introduction Evaluation of Head and Neck carcinoma includes clinical assessment of primary and neck. In addition to clinical examination cross sectional imaging is essential for assessment of loco-regional disease as well as distant metastasis. Despite its cost, use of PET–CT scan has increased in the recent times for the assessment of the Head and Neck Cancers as it covers a larger area from the head to the thigh and also has an advantage of giving metabolic functional data which aids in better assessment of the cancer.
123
Indian J Otolaryngol Head Neck Surg
According to 2017 NCCN
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