Diagnostic sensitivity of 18fluorodeoxyglucose positron emission tomography for detecting synchronous multiple primary cancers in head and neck cancer patients
Department of Biology and Function in the Head and Neck, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan. Archives of Oto-Rhino-Laryngology
(Impact Factor: 1.55).
10/2011; 269(5):1503-7. DOI: 10.1007/s00405-011-1784-7
We assessed the sensitivity of positron emission tomography (PET) for detecting synchronous multiple primary cancers, particularly synchronous esophageal cancers in head and neck cancer patients. We retrospectively reviewed 230 head and neck cancer patients. All the patients routinely underwent the following examinations: urinalysis, occult blood, tumor marker detection [squamous cell carcinoma (SCC), cytokeratin fragment (CYFRA), and carcinoembryonic antigen (CEA)], esophagogastroduodenoscopy, colonoscopy (when CEA was high or occult blood was positive), abdominal ultrasonography, plain chest computed tomography (CT), and PET. Bronchoscopy was performed when CT revealed lung shadow of central region. Synchronous multiple primary cancers were detected in 42 (18.2%) patients. The diagnostic sensitivity of PET for synchronous primary cancers was as follows: esophagus, 7.6% (1/13); stomach, 25.0% (2/8); lung, 66.7% (4/6); head and neck, 75.0% (3/4); colon, 0% (0/1); kidney, 0% (0/1); and subcutaneous, 100% (1/1). The sensitivity of PET for detecting synchronous esophageal cancers is low because these are early-stage cancers (almost stage 0-I). Therefore, it is necessary to perform esophagogastroduodenoscopy for detecting synchronous esophageal cancers. PET is an important additional tool for detecting synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous head and neck cancer and lung cancer is high. But PET has the limitation of sensitivity for synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous esophageal cancer is very low.
Available from: Mine Silindir Gunay
- "PET can characterize benign or malign character of tumor correctly and diagnose metastases early (Kumar et al. 2003). 18 F-FDG can be used in the diagnosis and evaluation of outcome prediction and disease extension in several tumors such as small cell lung cancer (Arslan et al. 2011), head and neck canncers (Kondo et al. 2011), extranodal lymphoma (Ilica et al. 2011), cervical carcinoma (Cetina et al. 2011), colorectal tumors (Peng et al. 2011) and so on. Therefore, depening on its sensitivity the physician can decide therapy plan such as applying chemotherapy or surgery. "
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ABSTRACT: Among different imaging modalities, Positron Emission Tomography (PET) gained importance in routine hospital practice depending on ability to diagnose diseases in early stages and tracing of therapy by obtaining metabolic information. The combination of PET with Computed Tomography (CT) forms hybrid imaging modality that gives chance to obtain better images having higher resolution by fusing both functional and anatomical images in the same imaging modality at the same time. Therefore, better contrast agents are essentially needed. The advance in research about developing drug delivery systems as specific nanosized targeted systems gained an additional importance for obtaining better diagnosis and therapy of different diseases. Liposomes appear to be more attractive drug delivery systems in delivering either drugs or imaging ligands to target tissue or organ of diseases with higher accumulation by producing in nano-scale, long circulating by stealth effect and specific targeting by modifying with specific ligands or markers. The combination of positron emitting radionuclides with liposomes are commonly in research level nowadays and there is no commercially available liposome formulation for PET imaging. However by conjugating positron emitter radionuclide with liposomes can form promising diagnostic agents for improved diagnosis and following up treatments by increasing image signal/contrast in the target tissue in lower concentrations by specific targeting as the most important advantage of liposomes. More accurate and earlier diagnosis of several diseases can be obtained even in molecular level with the use of stable and effectively radiolabeled molecular target specific nano sized liposomes with longer half-lived positron emitting radionuclides.
Available from: Thomas Wilhelm
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Reliable diagnosis plays an important role in the early detection of head and neck tumors. The objective of this study was to compare the value and clinical relevance of magnetic resonance imaging (MRI) and positron emission tomography (PET) regarding the assessment and the identification of head and neck tumors.
Patients and methods:
From January 1, 2005, to January 1, 2007, 120 patients suffering from carcinomas of the oropharynx and larynx were examined by means of MRI and PET.
The difference between sensitivity and specificity of MRI and PET was not significant with regard to the diagnosis of primary tumors, recurrence, or cancer of unknown primary. A statistically significant difference between both methods only occurred for detectron of malignant lymph nodes of size >10 mm.
In particular, the assessment of small tumors by MRI and PET is characterized by a high number of false-negative findings. The future of diagnostic imaging is likely to be a combination of both techniques, as a hybrid technique.
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ABSTRACT: Aim: We investigated the significance of pre-treatment screening by (18)F-fluorodeoxyglucose positron-emission tomography (FDG-PET) in patients with esophageal cancer.
We retrospectively evaluated the clinical significance of screening in 200 patients with primary esophageal cancer using FDG-PET.
Out of 200 patients, 34 (17%) had synchronous multiple primary tumors; 31 patients had two types of cancers (15.5%) and three patients had three types (1.5%). The 37 second and third primary tumors were 13 stomach cancers (35.1%), 13 head and neck cancers (35.1%), seven colon (18.9%) and two lung (5.4%) cancers. When PET was performed at initial treatment for esophageal cancer, the diagnostic sensitivity of FDG-PET/Computed tomography (CT) for the second and third synchronous primary cancer were 53.8% (7/13) for the stomach; head and neck, 61.5% (8/13); colon, 42.9% (3/7); and lung, 50% (1/2), for an overall sensitivity of 54.1% (20/37 sites).
FDG-PET/CT for patients with esophageal cancer may find both metastases from the primary esophageal cancer and other types of synchronous primary cancers.
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