Case Studies

PET/CT exam findings comparing localized laryngeal head and neck cancer at two timepoints. Bottom row staging PET/CT images (left to right: CT, PET/CT and PET Scan) show a baseline PET/CT exam confirming a localized primary laryngeal lesion (arrowed) with no visual evidence for metastasis. Subsequent oncology treatment response on top row of PET/CT images (left to right: CT, PET/CT and PET Scan) was performed post radiation therapy showing a complete response with no visualized lesion present (top row arrow).

“Head and neck cancers are malignancies that arise in the nasal cavity, sinuses, lips, mouth, salivary glands, throat, or larynx. These cancers usually begin in the squamous cells that line the moist mucosal surfaces inside the head and neck such as in the mouth, nose, and throat.

Including cancers of the oral cavity, pharynx, and larynx, the National Cancer Institute estimates that about 66,920 people in the United States will be diagnosed with head and neck cancer in 2023, and about 15,400 will die from these diseases. These cancers are nearly twice as common among men as they are among women.”

Source: AACR

“There is evidence to support the superiority of FDG PET/CT for detecting locoregional nodal and distant metastases in patients with H&N cancers. A meta-analysis including 18 studies showed that the positive predictive value (PPV) and negative predictive value (NPV) of FDG PET/CT for detection of cervical lymph node involvement in patients with clinically node-negative SCCHN was 0.62 (95% CI, 0.55–0.69) and 0.83 (95% CI, 0.79–0.86), respectively. 80 Analyses from the prospective ACRIN 6685 study (SCCHN; 64% oral cavity) showed that, in patients with cN0 disease, 125/144 (87%) negative PET scans were pathologically negative at neck dissection. Findings from PET/CT changed the surgical plan in 22% of patients. A prospective single-center study from Germany (N =150) showed an NPV of 93.3% (95% CI, 88.2%–98.5%) for detection of cervical lymph node metastases by FDG PET/CT.”

Permission Pending from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers Version 2.2023 — May 15, 2023— © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed August 15, 2023. To view the most recent and complete version of the guideline, go online to NCCN.org.

Source: NCCN (page 147, MS-7)