The Role of PET/CT with 18 F-FDG in the Assessment of Therapeutic Response of Head and Neck Cancer

Abstract

Purpose of Review

To make a brief review on the pre-treatment evaluation of head and neck squamous cell carcinoma (HNSCC) with positron emission tomography/computed tomography with 18F-Fluoro-deoxy-glucose (¹⁸F-FDG PET/CT) and to discuss the use of this method after treatment, with emphasis on the evaluation of therapeutic response.

Recent Findings

The ¹⁸F-FDG PET/CT pre-treatment evaluation is recommended at III–IV staging to determine metastasis foci. At post-evaluation, the use of ¹⁸F-FDG PET/CT is very important to confirm the therapeutic response based on its high negative predictive value (NPV), mostly when it is made after 12 weeks the last radiotherapy dose. Specific imaging criteria aid in the detection of active tumor lesions. Moreover, the ¹⁸F-FDG PET/CT can determine early failure treatment and overall survival and progression-free survival. Recently, the ¹⁸F-FDG PET/CT surveillance was showed an important tool to follow up HNSCC patients with stage N2 or N3 disease.

Summary

The ¹⁸F-FDG PET/CT is essential in the management of HNSCC, mainly at post-treatment evaluation. Its findings can determine a complementary therapy or even avoid an aggressive and unnecessary approach. So, careful analysis using imaging interpretation criteria has been central to an accurate assessment of HNSCC patients.

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