Combining CT, FDG-PET Provides More Accurate, Customized Treatments for Head and Neck Cancer Patients

Combining computerized tomography (CT) with fluorodeoxyglucose positron emission tomography (FDG-PET) imaging results in considerably more defined tumor outlines and potentially different treatment options in head and neck cancer patients compared to using CT alone.

The study's findings were presented in April 2011 at the Cancer Imaging and Radiation Therapy Symposium in Atlanta, GA, USA. This symposium is cosponsored by the American Society for Radiation Oncology (ASTRO; Fairfax, VA, USA) and the Radiological Society of North America (RSNA, Oak Brook, IL, USA).

CT is the standard method for determining tumor delineation before deciding head and neck cancer treatment-typically intensity modulated radiation therapy. However, FDG-PET is an imaging technique that utilizes a radioactive product combined with sugar and can generate better-defined outlines of the tumor.

Researchers tried to determine the significance of combining CT and FDG-PET when determining tumor delineation and treatment for head and neck cancer patients. In this trial, 327 patients were treated with IMRT for head and neck cancer. Based on the combined application of the CT scan and FDG-PET, the researchers noticed a change in the delineation of the tumor in one out of three patients, resulting in 10% of patients' treatment being changed and 33% of patients having their treatment adjusted.

In 17% of the patients, the primary tumor was not visible on the CT scan alone, mostly because of dental inlays.

"We expected there to be an improved delineation of the tumor," Homan Dehnad, MD, a study author and radiation oncologist at Utrecht University Medical Center (The Netherlands) said. "However, we never expected it to have such an influence on the treatment options for patients. Each dedicated institute dealing with head and neck cancer should be equipped with multi-imaged facilities."

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Utrecht University Medical Center