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[头颈部鳞状细胞癌成像的当前肿瘤学概念与新兴技术]

[Current oncologic concepts and emerging techniques for imaging of head and neck squamous cell cancer].

作者信息

Sadick M, Schoenberg S O, Hoermann K, Sadick H

机构信息

Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg.

出版信息

Laryngorhinootologie. 2012 Mar;91 Suppl 1:S27-47. doi: 10.1055/s-0031-1297259. Epub 2012 Mar 28.

Abstract

The incidence of head and neck squamous cell carcinoma (HNSCC) is increasing and currently they account for 5% of all malignancies worldwide. Inspite of ongoing developments in diagnostic imaging and new therapeutic facilities, HNSCC still represents a multidisciplinary challenge. One of the most important prognostic factors in HNSCC is the presence of lymph node metastases. Patients with confirmed nodal involvement have a considerable reduction of their 5-year overall survival rate. In the era of individually optimised surgery, chemotherapy and intensity modulated radiotherapy, the main role of pre- and posttherapeutic imaging remains cancer detection at an early stage and accurate follow-up. The combined effort of early diagnosis and close patient monitoring after surgery and/or radio-chemotherapy influences disease progression and outcome prediction in patients with HNSCC. This review article focuses on currrent oncologic concepts and emerging tools in imaging of head and neck squamous cell cancer. Besides the diagnostic spectrum of the individual imaging modalities, their limitations are also discussed. One main part of this article is dedicated to PET-CT which combines functional and morphological imaging. Furthermore latest developments in MRT are presented with regard to lymph node staging and response prediction. Last but not least, a clinical contribution in this review explains, which information the head and neck surgeon requires from the multimodality imaging and its impact on operation planning.

摘要

头颈部鳞状细胞癌(HNSCC)的发病率正在上升,目前占全球所有恶性肿瘤的5%。尽管诊断成像和新的治疗设施不断发展,但HNSCC仍然是一个多学科挑战。HNSCC最重要的预后因素之一是淋巴结转移的存在。确诊有淋巴结受累的患者其5年总生存率会大幅降低。在个体化优化手术、化疗和调强放疗的时代,治疗前和治疗后成像的主要作用仍然是早期癌症检测和准确随访。早期诊断以及术后和/或放化疗后对患者的密切监测共同影响着HNSCC患者的疾病进展和预后预测。这篇综述文章重点关注头颈部鳞状细胞癌成像的当前肿瘤学概念和新兴工具。除了各种成像方式的诊断范围外,还讨论了它们的局限性。本文的一个主要部分专门介绍了结合功能和形态成像的PET-CT。此外,还介绍了磁共振成像(MRT)在淋巴结分期和反应预测方面的最新进展。最后但同样重要的是,本综述中的临床贡献解释了头颈外科医生从多模态成像中需要哪些信息以及其对手术规划的影响。

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