18F-FDG-PET/CT interpretation pitfalls in patients with head and neck cancer
Nikolaos Tsetsos1, Alexandros Poutoglidis1, Georgios Arsos2
1Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
Aim:
The aim of the present study is to raise awareness of ENT Surgeons on the limitations of 18F-FDG PET/CT in head and neck cancer by presenting illustrative cases from our department archives.
Materials And Methods:
A retrospective chart review was conducted for all patients with head and neck cancer treated in our ENT department from 2015 to 2020. Cases with various interpretation pitfalls due to false-positive and false-negative PET/CT results that lead to diagnostic dilemmas and treatment delays either in their pre-therapeutic work-up or in their post-therapeutic monitoring were included.
Results:
Five cases of various image interpretation pitfalls (3 false negative and 2 false positive cases) were identified and are presented in detail.
Conclusions:
Although 18F-FDG PET/CT has gained in popularity and improved head and neck cancer management, clinicians should be aware of its limitations. The combination of 18F-FDG PET/CT with other imaging modalities can reduce the number of interpretation pitfalls but by no means will substitute sound clinical judgement.
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