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. 2020 Dec 1;4(1):22.
doi: 10.1186/s41824-020-00091-x.

18F-FDG-PET/CT in radiation therapy-induced parotid gland inflammation

Alaa Mouminah  1   2 , Austin J Borja  1   3 , Emily C Hancin  1   4 , Yu Cheng Chang  2 , Thomas J Werner  1 , Samuel Swisher-McClure  5 , Jonathan Korostoff  2 , Abass Alavi  1 , Mona-Elisabeth Revheim  6   7   8
Affiliations

18F-FDG-PET/CT in radiation therapy-induced parotid gland inflammation

Alaa Mouminah et al. Eur J Hybrid Imaging. .

Abstract

Background: 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used in the clinical management of oncologic and inflammatory pathologies. It may have utility in detecting radiotherapy (RT)-induced damage of oral tissues. Thus, the aim of the present study was to use FDG-PET/CT to evaluate parotid gland inflammation following RT in patients with head and neck cancer (HNC).

Methods: This retrospective study included patients with HNC treated with photon, proton, or combined photon/proton RT, in addition to chemotherapy. All patients received FDG-PET/CT imaging pre-treatment and 3 months post-treatment. The average mean standardized uptake value (Avg SUVmean) and the average maximum standardized uptake value (Avg SUVmax) of the left and right parotid glands were determined by global assessment of FDG activity using OsiriX MD software. A two-tailed paired t test was used to compare Avg SUVmean and Avg SUVmax pre- and post-RT.

Results: Forty-seven HNC patients were included in the study. Parotid gland Avg SUVmean was significantly higher at 3 months post-treatment than pre-treatment (p < 0.05) in patients treated with photon RT, but no significant differences were found between pre- and post-treatment Avg SUVmean in patients treated with proton RT or combined photon/proton RT.

Conclusion: Our results suggest that photon RT may cause radiation-induced inflammation of the parotid gland, and that proton RT, which distributes less off-target radiation, is a safer treatment alternative.

Keywords: 18F-FDG; Head and neck cancer; PET/CT; Parotid gland; Parotid gland inflammation; Radiation therapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) images of the parotid gland. Left: Fused FDG PET/CT, right: CT. The delineation of the region of interest (ROI) is highlighted for the right and left parotid glands
Fig. 2
Fig. 2
Changes in average standardized uptake value mean (Avg SUVmean) of the parotid gland before and 3 months after treatment in patients treated with photon RT
Fig. 3
Fig. 3
Changes in average standardized uptake value mean (Avg SUVmean) of the parotid gland before and 3 months after treatment in patients treated with proton RT
Fig. 4
Fig. 4
Changes in average standardized uptake value mean (Avg SUVmean) of the parotid gland before and 3 months after treatment in patients treated with combined photon/proton RT
See this image and copyright information in PMC

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