Effectiveness of PET/CT with (18)F-fluorothymidine in the staging of patients with squamous cell head and neck carcinomas before radiotherapy

Abstract

Aim: The aim of our study was to compare the staging of the disease declared before anticancer treatment was begun with the staging that was found after the planning PET/CT scanning with (18)F-FLT was performed.

Background: PET/CT in radiotherapy planning of head and neck cancers can facilitate the contouring of the primary tumour and the definition of metastatic lymph nodes.

Materials and methods: Between November 2010 and November 2013, 26 patients suffering from head and neck carcinomas underwent planning PET/CT examination with (18)F-FLT. We compared the staging of the disease and the treatment strategy declared before and after (18)F-FLT-PET/CT was performed.

Results: The findings from (18)FLT-PET/CT led in 22 patients to a change of staging: in 19 patients it led to upstaging of the disease and in 3 patients it led to downstaging of the disease. In one patient, a secondary malignancy was found.

Conclusions: We have confirmed in this study that the use of (18)F-FLT-PET/CT scanning in radiotherapy planning of squamous cell head and neck carcinomas has a great potential in the precise evaluation of disease staging and consequently in the precise determination of target volumes.

Keywords: 18F-fluorothymidine; Head and neck carcinomas; PET/CT; Radiotherapy planning.

Fig. 1

Patient (no. 6) with paranasal sinus carcinoma – axial (a) and coronal (b) view. According to the staging ultrasound investigation only benign cervical lymph nodes bilaterally. In the right upper jugular region increased FLT accumulation due to tumour infiltration, on the left side reactively changed node.

Fig. 2

Patient (no. 7) with carcinoma of the right edge of the tongue (a, c) with secondary malignancy in the left paralaryngeal space (b, c). Axial (a, b) and coronal view (c).