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18F-FDG PET/CT quantification in head and neck squamous cell cancer: principles, technical issues and clinical applications

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Abstract

18F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. 18F-FDG PET/CT is also used for precise delineation of the tumour volume for radiation therapy planning and dose painting, and for treatment response monitoring, by detecting residual or recurrent disease. Most of these applications would benefit from a quantitative approach to the disease, but the quantitative capability of 18F-FDG PET/CT is still underused in HNSCC. Innovations in PET/CT technology promise to overcome the issues that until now have hindered the employment of dynamic procedures in clinical practice and have limited “quantification” to the evaluation of standardized uptake values (SUV), de facto a semiquantitative parameter, the limits of which are well known to the nuclear medicine community. In this paper the principles of quantitative imaging and the related technical issues are reviewed so that professionals involved in HNSCC management can reflect on the advantages of “true” quantification. A discussion is then presented on how semiquantitative information is currently used in clinical 18F-FDG PET/CT applications in HNSCC, by discussing the improvements that could be obtained with more advanced and “personalized” quantification techniques.

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References

  1. Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Soret M, Bacharach S, Buvat I. Partial-volume effect in PET tumor imaging. J Nucl Med. 2007;48:932–45.

    Article  PubMed  Google Scholar 

  3. Sokoloff L, Reivich M, Kennedy C, Des Rosiers M, Patlak C, Pettigrew K, et al. The [14C]deoxyglucose method for the measurement of local cerebral glucose utilization: theory, procedure, and normal values in the conscious and anesthetized albino rat. J Neurochem. 1977;28:897–916.

    Article  CAS  PubMed  Google Scholar 

  4. Patlak CS, Blasberg RG, Fenstermacher JD. Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. J Cereb Blood Flow Metab. 1983;3:1–7.

    Article  CAS  PubMed  Google Scholar 

  5. Cheebsumon P, Velasquez LM, Hoekstra CJ, Hayes W, Kloet RW, Hoetjes NJ, et al. Measuring response to therapy using FDG PET: semi-quantitative and full kinetic analysis. Eur J Nucl Med Mol Imaging. 2011;38:832–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Hoekstra CJ, Hoekstra OS, Stroobants SG, Vansteenkiste J, Nuyts J, Smit EF, et al. Methods to monitor response to chemotherapy. J Nucl Med. 2002;43:1304–9.

    CAS  PubMed  Google Scholar 

  7. Krak NC, van der Hoeven JJM, Hoekstra OS, Twisk JWR, van der Wall E, Lammertsma AA. Measuring [18F]FDG uptake in breast cancer during chemotherapy: comparison of analytical methods. Eur J Nucl Med Mol Imaging. 2003;30:674–81.

    Article  CAS  PubMed  Google Scholar 

  8. Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999;35:1773–82.

    Article  CAS  PubMed  Google Scholar 

  9. Kim CK, Gupta N, Chandramouli B, Alavi A. Standardized uptake values of FDG: body surface area correction is preferable to body weight correction. J Nucl Med. 1994;35:164–7.

    CAS  PubMed  Google Scholar 

  10. Zasadny KR, Wahl RL. Standardized uptake values of normal tissues at PET with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose: variations with body weight and a method for correction. Radiology. 1993;189:847–50.

    Article  CAS  PubMed  Google Scholar 

  11. Huang SC. Anatomy of SUV. Nucl Med Biol. 2000;27:643–6.

    Article  CAS  PubMed  Google Scholar 

  12. Keyes JW. SUV: standard uptake or silly useless value? J Nucl Med. 1995;36:1836–9.

    PubMed  Google Scholar 

  13. Weber WA. Use of PET for monitoring cancer therapy and for predicting outcome. J Nucl Med. 2005;46:983–95.

  14. Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50:11S–20.

  15. Kroep JR, Van Groeningen CJ, Cuesta MA, Craanen ME, Hoekstra OS, Comans EF, et al. Positron emission tomography using 2-deoxy-2-[18F]-fluoro-D-glucose for response monitoring in locally advanced gastroesophageal cancer; a comparison of different analytical methods. Mol Imaging Biol. 2003;5:337–46.

    Article  PubMed  Google Scholar 

  16. Kole AC, Nieweg OE, Pruim J, Paans AMJ, Plukker JTM, Hoekstra HJ, et al. Standardized uptake value and quantification of metabolism for breast cancer imaging with FDG and L-[1-11C]Tyrosine PET. J Nucl Med. 1997;38:692–6.

    CAS  PubMed  Google Scholar 

  17. de Geus-Oei LF, van der Heijden HFM, Visser EP, Hermsen R, van Hoorn BA, Timmer-Bonte JNH, et al. Chemotherapy response evaluation with 18F-FDG PET in patients with non-small cell lung cancer. J Nucl Med. 2007;48:1592–8.

    Article  PubMed  Google Scholar 

  18. de Geus-Oei LF, van Laarhoven HWM, Visser EP, Hermsen R, van Hoorn BA, Kamm YJL, et al. Chemotherapy response evaluation with FDG-PET in patients with colorectal cancer. Ann Oncol. 2008;19:348–52.

    Article  PubMed  Google Scholar 

  19. Weber WA, Petersen V, Schmidt B, Tyndale-Hines L, Link T, Peschel C, et al. Positron emission tomography in non-small-cell lung cancer: prediction of response to chemotherapy by quantitative assessment of glucose use. J Clin Oncol. 2003;21:2651–7.

    Article  CAS  PubMed  Google Scholar 

  20. Doot RK, Dunnwald LK, Schubert EK, Muzi M, Peterson LM, Kinahan PE, et al. Dynamic and static approaches to quantifying 18F-FDG uptake for measuring cancer response to therapy, including the effect of granulocyte CSF. J Nucl Med. 2007;48:920–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Dunnwald LK, Doot RK, Specht JM, Gralow JR, Ellis GK, Livingston RB, et al. PET tumor metabolism in locally advanced breast cancer patients undergoing neoadjuvant chemotherapy: value of static versus kinetic measures of fluorodeoxyglucose uptake. J Nucl Med. 2002;43:1304–9.

    Google Scholar 

  22. Avril N, Bense S, Ziegler SI, Dose J, Weber W, Laubenbacher C, et al. Breast imaging with fluorine-18-FDG PET: quantitative image analysis. J Nucl Med. 1997;38:1186–91.

    CAS  PubMed  Google Scholar 

  23. Nitzsche EU, Hoegerle S, Mix M, Brink I, Otte A, Moser E, et al. Non-invasive differentiation of pancreatic lesions: is analysis of FDG kinetics superior to semiquantitative uptake value analysis? Eur J Nucl Med. 2002;29:237–42.

    Article  Google Scholar 

  24. Wu H, Dimitrakopoulou-Strauss A, Heichel TO, Lehner B, Bernd L, Ewerbeck L, et al. Quantitative evaluation of skeletal tumours with dynamic FDG PET: SUV in comparison to Patlak analysis. Eur J Nucl Med. 2001;28:704–10.

    Article  CAS  PubMed  Google Scholar 

  25. Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: useful parameter or oversimplification? J Nucl Med. 1994;35:1308–12.

    CAS  PubMed  Google Scholar 

  26. Freedman NMT, Sundaram SK, Kurdziel K, Carrasquillo JA, Whatley M, Carson JM, et al. Comparison of SUV and Patlak slope for monitoring of cancer therapy using serial PET scans. Eur J Nucl Med. 2003;30:46–53.

    Article  Google Scholar 

  27. Visser EP, Philippens MEP, Kienhorst L, Kaanders JHAM, Corstens FHM, de Geus-Oei LF, et al. Comparison of tumor volumes derived from glucose metabolic rate maps and SUV maps in dynamic 18F-FDG PET. J Nucl Med. 2008;49:892–8.

    Article  PubMed  Google Scholar 

  28. Cheebsumon P, van Velden FHP, Yaqub M, Hoekstra CJ, Velasquez LM, Hayes W, et al. Measurement of metabolic tumor volume: static versus dynamic FDG scans. EJNMMI Res. 2011;1:35.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Chen K, Bandy D, Reiman E, Huang SC, Lawson M, Feng D, et al. Noninvasive quantification of the cerebral metabolic rate for glucose using positron emission tomography, 18F-fluoro-2-deoxyglucose, the Patlak method, and an image-derived input function. J Cereb Blood Flow Metab. 1998;18:716–23.

    Article  CAS  PubMed  Google Scholar 

  30. Dhawan V, Takikawa S, Robeson W, Spetsieris P, Chaly T, Dahl R, et al. Quantitative brain FDG/PET studies using dynamic aortic imaging. Phys Med Biol. 1994;39:1475–87.

    Article  CAS  PubMed  Google Scholar 

  31. Karakatsanis NA, Lodge MA, Tahari AK, Zhou Y, Wahl RL, Rahmim A. Dynamic whole body PET parametric imaging: I. Concept, acquisition protocol optimization and clinical application. Phys Med Biol. 2013;58:7391–418.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Braun H, Ziegler S, Lentschig MG, Quick HH. Implementation and performance evaluation of simultaneous PET/MR whole-body imaging with continuous table motion. J Nucl Med. 2014;55:161–8.

    Article  CAS  PubMed  Google Scholar 

  33. Kotasidis FA, Tsoumpas C, Rahmim A. Advanced kinetic modelling strategies: towards adoption in clinical PET imaging. Clin Transl Imaging. 2014;2:219–37.

    Article  Google Scholar 

  34. Tantiwongkosi B, Yu F, Kanard A, Miller FR. Role of (18)F-FDG PET/CT in pre and post treatment evaluation in head and neck carcinoma. World J Radiol. 2014;6:77–191.

    Article  Google Scholar 

  35. Rusthoven KE, Koshy M, Paulino AC. The role of fluorodeoxyglucose positron emission tomography in cervical lymph node metastases from an unknown primary tumor. Cancer. 2004;101:2641–9.

    Article  PubMed  Google Scholar 

  36. Rudmik L, Lau HY, Matthews TW, Bosch JD, Kloiber R, Molnar CP, et al. Clinical utility of PET/CT in the evaluation of head and neck squamous cell carcinoma with an unknown primary: a prospective clinical trial. Head Neck. 2011;33:935–40.

    Article  PubMed  Google Scholar 

  37. Pereira G, Silva JC, Monteiro E. Positron emission tomography in the detection of occult primary head and neck carcinoma: a retrospective study. Head Neck Oncol. 2012;4:34.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Kim SY, Roh JL, Kim MR, Kim JS, Choi SH, Nam SY, et al. Use of 18F-FDG PET for primary treatment strategy in patients with squamous cell carcinoma of the oropharynx. J Nucl Med. 2007;48:752–7.

    Article  PubMed  Google Scholar 

  39. Apostolova I, Steffen IG, Wedel F, Lougovski A, Marnitz S, Derlin T, et al. Asphericity of pretherapeutic tumour FDG uptake provides independent prognostic value in head-and-neck cancer. Eur Radiol. 2014;24:2077–87.

    Article  PubMed  Google Scholar 

  40. Schinagl DA, Span PN, Oyen WJ, Kaanders JH. Can FDG PET predict radiation treatment outcome in head and neck cancer? Results of a prospective study. Eur J Nucl Med Mol Imaging. 2011;38:1449–58.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Romesser PB, Lim R, Spratt DE, Setton J, Riaz N, Lok B, et al. The relative prognostic utility of standardized uptake value, gross tumor volume, and metabolic tumor volume in oropharyngeal cancer patients treated with platinum based concurrent chemoradiation with a pre-treatment [(18)F] fluorodeoxyglucose positron emission tomography scan. Oral Oncol. 2014;50:802–8.

    Article  CAS  PubMed  Google Scholar 

  42. Minn H, Lapela M, Klemi PJ, Grénman R, Leskinen S, Lindholm P, et al. Prediction of survival with fluorine-18-fluoro-deoxyglucose and PET in head and neck cancer. J Nucl Med. 1997;38:1907–11.

    CAS  PubMed  Google Scholar 

  43. Torizuka T, Tanizaki Y, Kanno T, Futatsubashi M, Naitou K, Ueda Y, et al. Prognostic value of 18F-FDG PET in patients with head and neck squamous cell cancer. AJR Am J Roentgenol. 2009;192:156–60.

    Article  Google Scholar 

  44. Liao CT, Chang JT, Wang HM, Ng SH, Hsueh C, Lee LY, et al. Pretreatment primary tumor SUVmax measured by FDG-PET and pathologic tumor depth predict for poor outcomes in patients with oral cavity squamous cell carcinoma and pathologically positive lymph nodes. Int J Radiat Oncol Biol Phys. 2009;73:764–71.

    Article  PubMed  Google Scholar 

  45. Kubicek GJ, Champ C, Fogh S, Wang F, Reddy E, Intenzo C, et al. FDG-PET staging and importance of lymph node SUV in head and neck cancer. Head Neck Oncol. 2010;2:19.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Greven KM, Williams DW, McGuirt WF, Harkness BA, D’Agostino RB, Keyes JW, et al. Serial positron emission tomography scans following radiation therapy of patients with head and neck cancer. Head Neck. 2001;23:942–6.

    Article  CAS  PubMed  Google Scholar 

  47. Vernon MR, Maheshwari M, Schultz CJ, Michel M, Wong SJ, Campbell BH, et al. Clinical outcomes of patients receiving integrated PET/CT-guided radiotherapy for head and neck carcinoma. Int J Radiat Oncol Biol Phys. 2008;70:678–84.

    Article  PubMed  Google Scholar 

  48. Xie P, Li M, Zhao H, Sun X, Fu Z, Yu J. 18F-FDG PET or PET-CT to evaluate prognosis for head and neck cancer: a meta-analysis. J Cancer Res Clin Oncol. 2011;137:1085–93.

    Article  PubMed  Google Scholar 

  49. Dibble EH, Alvarez AC, Truong MT, Mercier G, Cook EF, Subramaniam RM. 18F-FDG metabolic tumor volume and total glycolytic activity of oral cavity and oropharyngeal squamous cell cancer: adding value to clinical staging. J Nucl Med. 2012;53:709–15.

    Article  CAS  PubMed  Google Scholar 

  50. Romesser PB, Qureshi MM, Shah BA, Chatburn LT, Jalisi S, Devaiah AK, et al. Superior prognostic utility of gross and metabolic tumor volume compared to standardized uptake value using PET/CT in head and neck squamous cell carcinoma patients treated with intensity-modulated radiotherapy. Ann Nucl Med. 2012;26:527–34.

    Article  PubMed  PubMed Central  Google Scholar 

  51. La TH, Filion EJ, Turnbull BB, Chu JN, Lee P, Nguyen K, et al. Metabolic tumor volume predicts for recurrence and death in head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2009;74:1335–41.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Chan SC, Chang JT, Lin CY, Ng SH, Wang HM, Liao CT, et al. Clinical utility of 18F-FDG PET parameters in patients with advanced nasopharyngeal carcinoma: predictive role for different survival endpoints and impact on prognostic stratification. Nucl Med Commun. 2011;32:989–96.

    Article  PubMed  Google Scholar 

  53. Moon SH, Choi JY, Lee HJ, Son YI, Baek CH, Ahn YC, et al. Prognostic value of 18F-FDG PET/CT in patients with squamous cell carcinoma of the tonsil: comparisons of volume-based metabolic parameters. Head Neck. 2013;35:15–22.

    Article  PubMed  Google Scholar 

  54. Cheng NM, Chang JT, Huang CG, Tsan DL, Ng SH, Wang HM, et al. Prognostic value of pretreatment 18F-FDG PET/CT and human papillomavirus type 16 testing in locally advanced oropharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging. 2012;39:1673–84.

    Article  PubMed  Google Scholar 

  55. Adams S, Baum RP, Stuckensen T, Bitter K, Hör G. Prospective comparison of 18F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer. Eur J Nucl Med. 1998;25:1255–60.

    Article  CAS  PubMed  Google Scholar 

  56. Dammann F, Horger M, Mueller-Berg M, Schlemmer H, Claussen CD, Hoffman J, et al. Rational diagnosis of squamous cell carcinoma of the head and neck region: comparative evaluation of CT, MRI, and 18FDG PET. AJR Am J Roentgenol. 2005;184:1326–31.

    Article  PubMed  Google Scholar 

  57. Mendenhall WM, Morris CG, Hinerman RW, Malyapa RS, Amdur RJ. Definitive radiotherapy for nasopharyngeal carcinoma. Am J Clin Oncol. 2006;29:622–7.

    Article  PubMed  Google Scholar 

  58. Chu HR, Kim JH, Yoon DY, Hwang HS, Rho YS. Additional diagnostic value of (18)F-FDG PET-CT in detecting retropharyngeal nodal metastases. Otolaryngol Head Neck Surg. 2009;141:633–8.

    Article  PubMed  Google Scholar 

  59. Krabbe CA, Balink H, Roodenburg JL, Dol J, de Visscher JG. Performance of 18F-FDG PET/contrast-enhanced CT in the staging of squamous cell carcinoma of the oral cavity and oropharynx. Int J Oral Maxillofac Surg. 2011;40:1263–70.

    Article  CAS  PubMed  Google Scholar 

  60. Liao CT, Wang HM, Huang SF, Chen IH, Kang CJ, Lin CY, et al. PET and PET/CT of the neck lymph nodes improves risk prediction in patients with squamous cell carcinoma of the oral cavity. J Nucl Med. 2011;52:180–7.

    Article  PubMed  Google Scholar 

  61. Murakami R, Uozumi H, Hirai T, Nishimura R, Shiraishi S, Ota K, et al. Impact of FDG-PET/CT imaging on nodal staging for head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2007;68:377–82.

    Article  PubMed  Google Scholar 

  62. Nakagawa T, Yamada M, Suzuki Y. 18F-FDG uptake in reactive neck lymph nodes of oral cancer: relationship to lymphoid follicles. J Nucl Med. 2008;49:1053–9.

    Article  PubMed  Google Scholar 

  63. Ng SH, Yen TC, Chang JT, Chan SC, Ko SF, Wang HM, et al. Prospective study of [18F]fluorodeoxyglucose positron emission tomography and computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with palpably negative neck. J Clin Oncol. 2006;24:4371–6.

    Article  PubMed  Google Scholar 

  64. Siddiqui F, Yao M. Application of fluorodeoxyglucose positron emission tomography in the management of head and neck cancers. World J Radiol. 2014;28:238–51.

    Article  Google Scholar 

  65. Zhuang H, Kumar R, Mandel S, Alavi A. Investigation of thyroid, head, and neck cancers with PET. Radiol Clin N Am. 2004;42:1101–11.

    Article  PubMed  Google Scholar 

  66. Quon A, Fischbein NJ, McDougall IR, Le QT, Loo BW, Pinto H, et al. Clinical role of 18F-FDG PET/CT in the management of squamous cell carcinoma of the head and neck and thyroid carcinoma. J Nucl Med. 2007;48:58S–67.

  67. Schöder H, Yeung HW. Positron emission imaging of head and neck cancer, including thyroid carcinoma. Semin Nucl Med. 2004;34:180–9.

    Article  PubMed  Google Scholar 

  68. Nahmias C, Carlson ER, Duncan LD, Blodgett TM, Kennedy J, Long MJ, et al. Positron emission tomography/computerized tomography (PET/CT) scanning for preoperative staging of patients with oral/head and neck cancer. J Oral Maxillofac Surg. 2007;65:2524–35.

    Article  PubMed  Google Scholar 

  69. Schöder H, Carlson DL, Kraus DH, Stambuk HE, Gönen M, Erdi YE, et al. 18F-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI. J Nucl Med. 2006;47:755–62.

    PubMed  Google Scholar 

  70. Subramaniam RM, Davison JM, Parikh U, Abou-Zied M. Head and neck. In: Peller P, Subramaniam R, Guermazi A, editors. PET-CT and PET-MRI in oncology: a practical guide. Berlin: Springer; 2012. p. 63–76.

  71. Chung MK, Jeong HS, Park SG, Jang JY, Son YI, Choi JY, et al. Metabolic tumor volume of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography predicts short-term outcome to radiotherapy with or without chemotherapy in pharyngeal cancer. Clin Cancer Res. 2009;15:5861–8.

    Article  CAS  PubMed  Google Scholar 

  72. Chang KP, Tsang NM, Liao CT, Hsu CL, Chung MJ, Lo CW, et al. Prognostic significance of 18F-FDG PET parameters and plasma Epstein-Barr virus DNA load in patients with nasopharyngeal carcinoma. J Nucl Med. 2012;53:21–8.

    Article  CAS  PubMed  Google Scholar 

  73. Haerle SK, Schmid DT, Ahmad N, Hanym TF, Stoeckli SJ. The value of (18)F-FDG PET/CT for the detection of distant metastases in high-risk patients with head and neck squamous cell carcinoma. Oral Oncol. 2011;47:653–9.

    Article  PubMed  Google Scholar 

  74. Gao S, Li S, Yang X, Tang Q. 18FDG PET-CT for distant metastases in patients with recurrent head and neck cancer after definitive treatment. A meta-analysis. Oral Oncol. 2014;50:163–7.

    Article  CAS  PubMed  Google Scholar 

  75. Pfister DG, Ang KK, Brizel DM, Burtness BA, Busse PM, Caudell JJ, et al. Head and neck cancers, version 2.2013. Featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2013;11:917–23.

  76. Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50:122S–50.

  77. Nayak JV, Walvekar RR, Andrade RS, Daamen N, Lai SY, Argiris A, et al. Deferring planned neck dissection following chemoradiation for stage IV head and neck cancer: the utility of PET-CT. Laryngoscope. 2007;117:2129–34.

    Article  PubMed  Google Scholar 

  78. Ong SC, Schöder H, Lee NY, Patel SG, Carlson D, Fury M, et al. Clinical utility of 18F-FDG PET/CT in assessing the neck after concurrent chemoradiotherapy for locoregional advanced head and neck cancer. J Nucl Med. 2008;49:532–40.

    Article  PubMed  Google Scholar 

  79. Kao J, Vu HL, Genden EM, Mocherla B, Park EE, Packer S, et al. The diagnostic and prognostic utility of positron emission tomography/computed tomography-based follow-up after radiotherapy for head and neck cancer. Cancer. 2009;115:4586–94.

    Article  PubMed  Google Scholar 

  80. Wong WL, Ross P, Corcoran M. Evidence-based guideline recommendations on the use of positron emission tomography imaging in head and neck cancer from Ontario and guidelines in general – some observations. Clin Oncol. 2013;25:242–5.

    Article  Google Scholar 

  81. Inohara H, Enomoto K, Tomiyama Y, Yoshii T, Osaki Y, Higuchi I, et al. The role of CT and 18F-FDG PET in managing the neck in node-positive head and neck cancer after chemoradiotherapy. Acta Otolaryngol. 2009;129:893–9.

    Article  PubMed  Google Scholar 

  82. Rogers JW, Greven KM, McGuirt WF, Keyes JW, Williams DW, Watson NE, et al. Can post-RT neck dissection be omitted for patients with head-and-neck cancer who have a negative PET scan after definitive radiation therapy? Int J Radiat Oncol Biol Phys. 2004;58:694–7.

    Article  PubMed  Google Scholar 

  83. Porceddu SV, Jarmolowski E, Hicks RJ, Ware R, Weih L, Rischin D, et al. Utility of positron emission tomography for the detection of disease in residual neck nodes after (chemo)radiotherapy in head and neck cancer. Head Neck. 2005;27:175–81.

    Article  PubMed  Google Scholar 

  84. Yao M, Smith RB, Graham MM, Hoffman HT, Tan H, Funk GFGSM, et al. The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment. Int J Radiat Oncol Biol Phys. 2005;63:991–9.

    Article  PubMed  Google Scholar 

  85. Waldron JN, Gilbert RW, Eapen L, Hammond A, Hodson DI, Hendler A, et al. Results of an Ontario Clinical Oncology Group (OCOG) prospective cohort study on the use of FDG PET/CT to predict the need for neck dissection following radiation therapy of head and neck cancer (HNC). J Clin Oncol. 2011;29:5504.

    Google Scholar 

  86. Han MW, Ryu IS, Lee SW, Kim SB, Roh JL, Choi SH, et al. Can response to induction chemotherapy be a predictive marker for ultimate outcome in hypopharyngeal cancer? Otolaryngol Head Neck Surg. 2012;146:74–80.

    Article  PubMed  Google Scholar 

  87. McCollum AD, Burrell SC, Haddad RI, Norris CM, Tishler RB, Case MA, et al. Positron emission tomography with 18F-fluorodeoxyglucose to predict pathologic response after induction chemotherapy and definitive chemoradiotherapy in head and neck cancer. Head Neck. 2004;26:890–6.

    Article  PubMed  Google Scholar 

  88. Marcus C, Ciarallo A, Tahari AK, Mena E, Koch W, Wahl RL, et al. Head and neck PET/CT: therapy response interpretation criteria (Hopkins Criteria) – interreader reliability, accuracy, and survival outcomes. J Nucl Med. 2014;55:1411–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Guo N, YR F, Wang M, El Fakhri G, Li Q. 18F-FDG dynamic PET/CT is effective on early assessment of therapy response in patients with head and neck cancer. J Nucl Med. 2015;56:17.

    Google Scholar 

  90. Wong RJ. Current status of FDG-PET for head and neck cancer. J Surg Oncol. 2008;97:649–52.

    Article  PubMed  Google Scholar 

  91. Abgral R, Querellou S, Potard G, Le Roux PY, Le Duc-Pennec A, Marianovski R, et al. Does 18F-FDG PET/CT improve the detection of posttreatment recurrence of head and neck squamous cell carcinoma in patients negative for disease on clinical follow-up? J Nucl Med. 2009;50:24–9.

    Article  PubMed  Google Scholar 

  92. Wang YF, Liu RS, Chu PY, Chang FC, Tai SK, Tsai TL, et al. Positron emission tomography in surveillance of head and neck squamous cell carcinoma after definitive chemoradiotherapy. Head Neck. 2009;31:442–51.

    Article  PubMed  Google Scholar 

  93. Cermik TF, Mavi A, Acikgoz G, Houseni M, Dadparvar S, Alavi A. FDG PET in detecting primary and recurrent malignant salivary gland tumors. Clin Nucl Med. 2007;32:286–91.

    Article  PubMed  Google Scholar 

  94. Salaun PY, Abgral R, Querellou S, Couturier O, Valette G, Bizais Y, et al. Does 18fluoro-fluorodeoxyglucose positron emission tomography improve recurrence detection in patients treated for head and neck squamous cell carcinoma with negative clinical follow-up? Head Neck. 2007;29:1115–20.

    Article  PubMed  Google Scholar 

  95. Goerres GW, Schmid DT, Bandhauer F, Huguenin PU, von Schulthess GK, Schmid S, et al. Positron emission tomography in the early follow-up of advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 2004;130:105–9.

    Article  PubMed  Google Scholar 

  96. Kubota K, Yokoyama J, Yamaguchi K, Ono S, Qureshy A, Itoh M, et al. FDG-PET delayed imaging for the detection of head and neck cancer recurrence after radio-chemotherapy: comparison with MRI/CT. Eur J Nucl Med Mol Imaging. 2004;31:590–5.

    Article  PubMed  Google Scholar 

  97. Yao M, Smith RB, Hoffman HT, Funk GF, Lu M, Menda Y, et al. Clinical significance of postradiotherapy [18F]-fluorodeoxyglucose positron emission tomography imaging in management of head-and-neck cancer – a long-term outcome report. Int J Radiat Oncol Biol Phys. 2009;74:9–14.

    Article  CAS  PubMed  Google Scholar 

  98. Wong RJ, Lin DT, Schöder H, Patel SG, Gonen M, Wolden S, et al. Diagnostic and prognostic value of [(18)F]fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma. J Clin Oncol. 2002;20:4199–208.

    Article  CAS  PubMed  Google Scholar 

  99. Nishioka T, Shiga T, Shirato H, Tsukamoto E, Tsuchiya K, Kato T, et al. Image fusion between FDG-PET and MRI/CT for radiotherapy planning of oropharyngeal and nasopharyngeal carcinomas. Int J Radiat Oncol Biol Phys. 2002;53:1051–7.

    Article  PubMed  Google Scholar 

  100. Wang D, Schultz CJ, Jursinic PA, Bialkowski M, Zhu XR, Brown WD, et al. Initial experience of FDG-PET/CT guided IMRT of head-and-neck carcinoma. Int J Radiat Oncol Biol Phys. 2006;65:143–51.

    Article  PubMed  Google Scholar 

  101. Wang K, Heron DE, Flickinger JC, Rwigema JC, Ferris RL, Kubicek GJ, et al. A retrospective, deformable registration analysis of the impact of PET-CT planning on patterns of failure in stereotactic body radiation therapy for recurrent head and neck cancer. Head Neck Oncol. 2012;4:12.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Cannon DM, Lee NY. Recurrence in region of spared parotid gland after definitive intensity-modulated radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2008;70:660–5.

    Article  PubMed  Google Scholar 

  103. Daisne JF, Duprez T, Weynand B, Lonneux M, Hamoir M, Reychler H, et al. Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging, and FDG PET and validation with surgical specimen. Radiology. 2004;233:93–100.

    Article  PubMed  Google Scholar 

  104. Caldas-Magalhaes J, Kasperts N, Kooij N, van den Berg CA, Terhaard CH, Raaijmakers CP, et al. Validation of imaging with pathology in laryngeal cancer: accuracy of the registration methodology. Int J Radiat Oncol Biol Phys. 2012;82:e289–98.

    Article  PubMed  Google Scholar 

  105. Schinagl DA, Span PN, van den Hoogen FJ, Merkx MA, Slootweg PJ, Oyen WJ, et al. Pathology-based validation of FDG PET segmentation tools for volume assessment of lymph node metastases from head and neck cancer. Eur J Nucl Med Mol Imaging. 2013;40:1828–35.

    Article  PubMed  Google Scholar 

  106. Ciernik IF, Dizendorf E, Baumert BG, Reiner B, Burger C, Davis JB, et al. Radiation treatment planning with an integrated positron emission and computer tomography (PET/CT): a feasibility study. Int J Radiat Oncol Biol Phys. 2003;57:853–63.

    Article  PubMed  Google Scholar 

  107. Riegel AC, Berson AM, Destian S, Ng T, Tena LB, Mitnick RJ, et al. Variability of gross tumor volume delineation in head-and-neck cancer using CT and PET/CT fusion. Int J Radiat Oncol Biol Phys. 2006;65:726–32.

    Article  PubMed  Google Scholar 

  108. Scarfone C, Lavely WC, Cmelak AJ, Delbeke D, Martin WH, Billheimer D, et al. Prospective feasibility trial of radiotherapy target definition for head and neck cancer using 3-dimensional PET and CT imaging. J Nucl Med. 2004;45:543–52.

    PubMed  Google Scholar 

  109. Breen SL, Publicover J, De Silva S, Pond G, Brock K, O’Sullivan B, et al. Intraobserver and interobserver variability in GTV delineation on FDG-PET-CT images of head and neck cancers. Int J Radiat Oncol Biol Phys. 2007;68:763–70.

    Article  PubMed  Google Scholar 

  110. Geets X, Tomsej M, Lee JA, Duprez T, Coche E, Cosnard G, et al. Adaptive biological image-guided IMRT with anatomic and functional imaging in pharyngo-laryngeal tumors: impact on target volume delineation and dose distribution using helical tomotherapy. Radiother Oncol. 2007;85:105–15.

    Article  PubMed  Google Scholar 

  111. Delouya G, Igidbashian L, Houle A, Belair M, Boucher L, Cohade C, et al. 18F-FDG-PET imaging in radiotherapy tumor volume delineation in treatment of head and neck cancer. Radiother Oncol. 2011;101:362–8.

    Article  PubMed  Google Scholar 

  112. Heron DE, Andrade RS, Flickinger J, Johnson J, Agarwala SS, Wu A, et al. Hybrid PET-CT simulation for radiation treatment planning in head-and-neck cancers: a brief technical report. Int J Radiat Oncol Biol Phys. 2004;60:1419–24.

    Article  PubMed  Google Scholar 

  113. Paulino AC, Koshy M, Howell R, Schuster D, Davis LW. Comparison of CT- and FDG-PET-defined gross tumor volume in intensity-modulated radiotherapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2005;61:1385–92.

    Article  PubMed  Google Scholar 

  114. Guido A, Fuccio L, Rombi B, Castellucci P, Cecconi A, Bunkheila F, et al. Combined 18F-FDG-PET/CT imaging in radiotherapy target delineation for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2009;73:759–63.

    Article  PubMed  Google Scholar 

  115. El-Bassiouni M, Ciernik IF, Davis JB, El-Attar I, Reiner B, Burger C, et al. [18FDG] PET-CT-based intensity-modulated radiotherapy treatment planning of head and neck cancer. Int J Radiat Oncol Biol Phys. 2007;69:286–93.

    Article  PubMed  Google Scholar 

  116. Deantonio L, Beldì D, Gambaro G, Loi G, Brambilla M, Inglese E, et al. FDG-PET/CT imaging for staging and radiotherapy treatment planning of head and neck carcinoma. Radiat Oncol. 2008;3:29.

    Article  PubMed  PubMed Central  Google Scholar 

  117. Zaidi H, Abdoli M, Fuentes CL, El Naqa IM. Comparative methods for PET image segmentation in pharyngolaryngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging. 2012;39:881–91.

    Article  PubMed  PubMed Central  Google Scholar 

  118. Schinagl DA, Vogel WV, Hoffmann AL, van Dalen JA, Oyen WJ, Kaanders JH. Comparison of five segmentation tools for 18F-fluoro-deoxy-glucose-positron emission tomography-based target volume definition in head and neck cancer. Int J Radiat Oncol Biol Phys. 2007;69:1282–9.

    Article  CAS  PubMed  Google Scholar 

  119. Thorwarth D, Schaefer A. Functional target volume delineation for radiation therapy on the basis of positron emission tomography and the correlation with histopathology. Q J Nucl Med Mol Imaging. 2010;54:490–9.

    CAS  PubMed  Google Scholar 

  120. Baek CH, Chung MK, Son YI, Choi JY, Kim HJ, Yim YJ, et al. Tumor volume assessment by 18F-FDG PET/CT in patients with oral cavity cancer with dental artifacts on CT or MR images. J Nucl Med. 2008;49:1422–8.

    Article  PubMed  Google Scholar 

  121. Burri RJ, Rangaswamy B, Kostakoglu L, Hoch B, Genden EM, Som PM, et al. Correlation of positron emission tomography standard uptake value and pathologic specimen size in cancer of the head and neck. Int J Radiat Oncol Biol Phys. 2008;71:682–8.

    Article  PubMed  Google Scholar 

  122. Murphy JD, Chisholm KM, Daly ME, Wiegner EA, Truong D, Iagaru A, et al. Correlation between metabolic tumor volume and pathologic tumor volume in squamous cell carcinoma of the oral cavity. Radiother Oncol. 2011;101:356–61.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Kubota R, Kubota K, Yamada S, Tada M, Ido T, Tamahashi N. Microautoradiographic study for the differentiation of intratumoral macrophages, granulation tissues and cancer cells by the dynamics of fluorine-18-fluorodeoxyglucose uptake. J Nucl Med. 1994;35:104–12.

    CAS  PubMed  Google Scholar 

  124. Chen H, Jiang J, Gao J, Liu D, Axelsson J, Cui M, et al. Tumor volumes measured from static and dynamic 18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography scan: comparison of different methods using magnetic resonance imaging as the criterion standard. J Comput Assist Tomogr. 2014;38:209–15.

    Article  PubMed  Google Scholar 

  125. Ling CC, Humm J, Larson S, Amols H, Fuks Z, Leibel S, et al. Towards multidimensional radiotherapy (MD-CRT): biological imaging and biological conformality. Int J Radiat Oncol Biol Phys. 2000;47:551–60.

    Article  CAS  PubMed  Google Scholar 

  126. Galvin JM, De Neve W. Intensity modulating and other radiation therapy devices for dose painting. J Clin Oncol. 2007;25:924–30.

    Article  PubMed  Google Scholar 

  127. Das SK, Miften MM, Zhou S, Bell M, Munley MT, Whiddon CS, et al. Feasibility of optimizing the dose distribution in lung tumors using fluorine-18-fluorodeoxyglucose positron emission tomography and single photon emission computed tomography guided dose prescriptions. Med Phys. 2004;31:1452–61.

    Article  CAS  PubMed  Google Scholar 

  128. Vanderstraeten B, Duthoy W, De Gersem W, De Neve W, Thierens H. [18F]fluoro-deoxy-glucose positron emission tomography ([18F]FDG-PET) voxel intensity-based intensity-modulated radiation therapy (IMRT) for head and neck cancer. Radiother Oncol. 2006;79:249–58.

    Article  CAS  PubMed  Google Scholar 

  129. Bowen SR, Flynn RT, Bentzen SM, Jeraj R. On the sensitivity of IMRT dose optimization to the mathematical form of a biological imaging-based prescription function. Phys Med Biol. 2009;54:1483–501.

    Article  PubMed  PubMed Central  Google Scholar 

  130. Thorwarth D, Eschmann SM, Paulsen F, Alber M. Hypoxia dose painting by numbers: a planning study. Int J Radiat Oncol Biol Phys. 2007;68:291–300.

    Article  PubMed  Google Scholar 

  131. Schwartz DL, Ford EC, Rajendran J, Yueh B, Coltrera MD, Virgin J, et al. FDG-PET/CT-guided intensity modulated head and neck radiotherapy: a pilot investigation. Head Neck. 2005;27:478–87.

    Article  PubMed  Google Scholar 

  132. Madani I, Duthoy W, Derie C, De Gersem W, Boterberg T, Saerens M, et al. Positron emission tomography-guided, focal-dose escalation using intensity-modulated radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2007;68:126–35.

    Article  PubMed  Google Scholar 

  133. Duprez F, De Neve W, De Gersem W, Coghe M, Madani I. Adaptive dose painting by numbers for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2011;80:1045–55.

    Article  PubMed  Google Scholar 

  134. Madani I, Duprez F, Boterberg T, Van de Wiele C, Bonte K, Deron P, et al. Maximum tolerated dose in a phase I trial on adaptive dose painting by numbers for head and neck cancer. Radiother Oncol. 2011;101:351–5.

    Article  PubMed  Google Scholar 

  135. Berwouts D, Olteanu LAM, Duprez F, Vercauteren T, De Gersem W, De Neve W, et al. Three-phase adaptive dose-painting-by-numbers for head-and-neck cancer: initial results of the phase I clinical trial. Radiother Oncol. 2013;107:310–6.

    Article  PubMed  Google Scholar 

  136. Yan D, Vicini F, Wong J, Martinez A. Adaptive radiation therapy. Phys Med Biol. 1997;42:123–32.

    Article  CAS  PubMed  Google Scholar 

  137. Moule RN, Kayani I, Moinuddin SA, Meer K, Lemon C, Goodchild K, et al. The potential advantages of (18)FDG PET/CT-based target volume delineation in radiotherapy planning of head and neck cancer. Radiother Oncol. 2010;97:189–93.

    Article  PubMed  Google Scholar 

  138. Geets X, Daisne JF, Tomsej M, Duprez T, Lonneux M, Gregoire V. Impact of the type of imaging modality on target volumes delineation and dose distribution in pharyngo-laryngeal squamous cell carcinoma: comparison between pre- and per-treatment studies. Radiother Oncol. 2006;78:291–7.

    Article  PubMed  Google Scholar 

  139. Hentschel M, Appold S, Schreiber A, Abolmaali N, Abramyuk A, Dörr W, et al. Early FDG PET at 10 or 20 Gy under chemoradiotherapy is prognostic for locoregional control and overall survival in patients with head and neck cancer. Eur J Nucl Med Mol Imaging. 2011;38:1203–11.

    Article  PubMed  Google Scholar 

  140. Lammertsma AA, Hoekstra CJ, Giaccone G, Hoekstra OS. How should we analyze FDG PET studies for monitoring tumour response? Eur J Nucl Med Mol Imaging. 2006;33:S16–21.

    Article  Google Scholar 

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Authors and Affiliations

  1. Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy

    Gianpiero Manca & Duccio Volterrani

  2. Service of Medical Physics, University Hospital of Siena, Viale Bracci 16, Siena, 53100, Italy

    Eleonora Vanzi

  3. Department of Nuclear Medicine, Santa Maria della Misericordia Rovigo Hospital, Via Tre Martiri 140, 45100, Rovigo, Italy

    Domenico Rubello & Gaia Grassetto

  4. Médecine Nucléaire, Centre Hospitalier and Biophysique, Faculté Charles Mérieux, Lyon, France

    Francesco Giammarile

  5. Nuclear Medicine/Radiology Department, University of Michigan Hospital, Ann Arbor, MI, USA

    Ka Kit Wong

  6. Department of Veterans Affairs Health System, Nuclear Medicine Service, Ann Arbor, MI, USA

    Ka Kit Wong

  7. Department of Radiological Sciences, School of Medicine, University of Nottingham, Nottingham, UK

    Alan C. Perkins

  8. Department of Radiology, Southern University of California, Los Angeles, CA, USA

    Patrick M. Colletti

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  1. Gianpiero Manca
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Manca, G., Vanzi, E., Rubello, D. et al. 18F-FDG PET/CT quantification in head and neck squamous cell cancer: principles, technical issues and clinical applications. Eur J Nucl Med Mol Imaging 43, 1360–1375 (2016). https://doi.org/10.1007/s00259-015-3294-0

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