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Functional imaging of head and neck cancers
Patrick Emonts1, Pierre Bourgeois, Marc Lemort
1Department of Radiology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Current Opinion in Oncology
|April 18, 2009
Summary
Functional imaging, including PET and MRI, enhances head and neck cancer staging and detects residual disease. Techniques like sentinel lymph node scintigraphy improve lymph node assessment, aiding treatment decisions.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Head and neck squamous cell carcinoma (HNSCC) diagnosis relies on imaging.
- Traditional imaging focuses on structure and morphology, limiting detailed disease characterization.
Purpose of the Study:
- To review the role of advanced functional imaging techniques in HNSCC.
- To highlight improvements in staging, lymph node assessment, and post-treatment surveillance.
Main Methods:
- Review of functional imaging modalities: PET, SPECT, and MRI.
- Discussion of specific techniques: FDG-PET, sentinel lymph node scintigraphy, SPECT-CT, diffusion-weighted MRI, and perfusion MRI.
Main Results:
- FDG-PET sensitivity for lymph node involvement is limited (50%) without clinical signs.
- Sentinel lymph node scintigraphy offers a valid alternative to elective dissection, enhanced by SPECT-CT.
- FDG-PET is effective for detecting residual/recurrent HNSCC post-therapy and selecting patients for laryngoscopy.
- Diffusion-weighted MRI predicts lymph node malignancy and assesses treatment response early.
- Perfusion MRI evaluates tumor vascularity and drug effects.
Conclusions:
- Functional imaging significantly improves initial HNSCC staging.
- Advanced imaging techniques enhance the detection of residual or recurrent HNSCC after treatment.
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