Occult primary head and neck carcinoma: Role of positron emission tomography imaging

Frank R Miller, Cecelia E. Schmalbach, Ande Bao

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The PET study can identify the occult primary tumor in ∼30% of patients who present with an unknown primary tumor and have no detectable tumor using conventional methods including fiber-optic endoscopy and CT/MRI imaging. New generation PET scanners and PET-CT fusion may increase the accuracy and effectiveness in head and neck cancer patients. The fused PET-CT is superior to either modality alone in the assessment of head and neck malignancies. The ability to identify the occult primary tumor is imperative because it allows site-specific therapy in a more directed fashion and avoids the side effects of wide field radiation. The principle of PET imaging is based on the coincident detection of two opposite emitted gamma photons from the annihilation reaction between a positron and an electron. The most commonly used and clinically useful PET radiopharmaceutical is 18F-2-fluoro-2-deoxyglucose (18F-FDG), a glucose analog that is preferentially taken up by various types of neoplastic cells. 18F-FDG-PET imaging is valuable in head and neck cancer diagnosis, cancer staging, and assessing response to therapy. The future of PET imaging in head and neck cancer is likely to mature with the development of new PET tracers that allow for more accurate tumor detection with less uptake by the normal tissue. The new PET tracer carbon-11-choline detects squamous cell carcinoma with the accuracy equivalent to FDG-PET but has the advantage of less muscle uptake and shorter examination times.

Original languageEnglish (US)
Title of host publicationCancer Imaging
PublisherAcademic Press
Pages423-430
Number of pages8
ISBN (Print)9780123742124
DOIs
StatePublished - 2008

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Positron emission tomography
Positron-Emission Tomography
Tumors
Neck
Head
Carcinoma
Imaging techniques
Head and Neck Neoplasms
Fluorodeoxyglucose F18
Neoplasms
Unknown Primary Neoplasms
Electrons
Endoscopy
Radiopharmaceuticals
Neoplasm Staging
Positrons
Choline
Photons
Magnetic resonance imaging
Fiber optics

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Occult primary head and neck carcinoma : Role of positron emission tomography imaging. / Miller, Frank R; Schmalbach, Cecelia E.; Bao, Ande.

Cancer Imaging. Academic Press, 2008. p. 423-430.

Research output: Chapter in Book/Report/Conference proceedingChapter

Miller, Frank R ; Schmalbach, Cecelia E. ; Bao, Ande. / Occult primary head and neck carcinoma : Role of positron emission tomography imaging. Cancer Imaging. Academic Press, 2008. pp. 423-430
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