Application of positron emission tomography/computed tomography in radiation treatment planning for head and neck cancers

• 作者: David Schwartz Farzan Siddiqui Jiankui Yuan Min Yao Mitchell Machtay Musaddiq J Awan
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: HEAD and NECK CANCER RADIATION treatment PLANNING
• 年，卷（期）: 2015,（11）
• 页码范围: 382-393
• 页数: 12页
• 分类号: R739.91

摘要

18-fluorodeoxygluocose positron emission tomography/computed tomography(18FDG-PET/CT) provides significant information in multiple settings in the management of head and neck cancers(HNC). This article seeks to define the additional benefit of PET/CT as related to radiation treatment planning for squamous cell carcinomas(SCCs) of the head and neck through a review of relevant literature. By helping further define both primary and nodal volumes, radiation treatment planning can be improved using PET/CT. Special attention is paid to the independent benefit of PET/CT in targeting mucosal primaries as well as in detecting nodal metastases. The utility of PET/CT is also explored for treatment planning in the setting of SCC of unknown primary as PET/CT may help define a mucosal target volume by guiding biopsies for examination under anesthesia thus changing the treatment paradigm and limiting the extent of therapy. Implications of the use of PET/CT for proper target delineation in patients with artifact from dental procedures are discussed and the impact of dental artifact on CT-based PET attenuation correction is assessed. Finally, comment is made upon the role of PET/CT in the high-risk post-operative setting, particularly in the context of radiation dose escalation. Real case examples are used in these settings to elucidate the practical benefits of PET/CT as related to radiation treatment planning in HNCs.