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Feichtinger, M; Aigner, RM; Kärcher, H.
F-18 positron emission tomography and computed tomography image-fusion for image-guided detection of local recurrence in patients with head and neck cancer using a 3-dimensional navigation system: a preliminary report.
J Oral Maxillofac Surg. 2008; 66(1):193-200
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Autor/innen der Med Uni Graz:
Aigner Reingard
Feichtinger Matthias
Kärcher Hans
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Abstract:
[18F]-2-fluorodeoxyglucose positron emission tomography (F-18 FDG-PET) has played an important role recently in the staging process for squamous cell carcinoma of the head and neck (SCCHN).(1) Various studies show a high sensitivity and specificity in detection of nodal metastases with this imaging modality.(2-5) Moreover, FDG-PET also has played a significant role in differentiating residual/recurrent disease from treatment-induced normal tissue changes.(6) Some authors show a sensitivity and specificity up to 100%, in contrast to the 75% sensitivity and 80% specificity of computed tomography (Cl)/magnetic resonance imaging (MRI).(7-9) A major disadvantage, however, is the fact that this method yields only limited information on the exact anatomic location of the lesion detected.(10) For this reason combined PET and CT systems (PET/CT) have emerged as promising imaging modalities.(11,12) The almost synchronous image acquisition and exact co-registration of anatomic and metabolic data improves the anatomic localization of PET abnormalities and reduces the number of equivocal PET interpretations.(13,14) Rodel et al(15) showed that PET/CT significantly improved sensitivity, specificity, and accuracy of both PET and CT alone and allowed accurate diagnosis of 93% of lesions in 90% of patients with head and neck oncology. After radical surgery or radiation therapy for head and neck malignancies, however, normal tissue planes are altered substantially. The surgical treatment entails excision and complex reconstructive surgery involving distant soft and bony tissue transfer, which distorts anatomy significantly and renders postoperative imaging challenging. Additional radiotherapy further distorts local structures.(16) Thus even with this combined imaging modality the evaluation of the postradiotherapy patient remains difficult. Reassessment of the suspect region therefore is often done with extensive biopsies under anesthesia. With postradiotherapy patients, however, the risk of significant morbidity is increased.(17-19) Improved methods of detecting local recurrence in patients with SCCHN are needed. The aim of this study is to show a new method of matching FDG-PET and CT data sets on a commercially available navigation system for image-guided biopsy targeting in cases of suspected local recurrence of squamous cell carcinoma of the oral cavity. This preliminary report describes our early experience with this combined technique.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Carcinoma, Squamous Cell - radiography Carcinoma, Squamous Cell - radionuclide imaging Carcinoma, Squamous Cell - surgery
Fluorodeoxyglucose F18 - diagnostic use
Humans -
Image Processing, Computer-Assisted - methods
Jaw Neoplasms - radiography Jaw Neoplasms - radionuclide imaging Jaw Neoplasms - surgery
Male -
Middle Aged -
Neoplasm Recurrence, Local - radiography Neoplasm Recurrence, Local - radionuclide imaging Neoplasm Recurrence, Local - surgery
Positron-Emission Tomography - methods
Prospective Studies -
Radiopharmaceuticals - diagnostic use
Surgery, Computer-Assisted - instrumentation Surgery, Computer-Assisted - methods
Tomography, X-Ray Computed - methods
Tonsillar Neoplasms - radiography Tonsillar Neoplasms - radionuclide imaging Tonsillar Neoplasms - surgery

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