Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka 645-8585, Japan.
Jpn J Radiol. 2012 Jul;30(6):463-70. doi: 10.1007/s11604-012-0076-5. Epub 2012 Apr 5.
F-18 FDG PET/CT has been widely used to diagnose primary tumors and lymph node metastases and to evaluate the response of head and neck squamous cell carcinoma (HNSCC) to therapy. The advantage of using PET/CT is that this combination allows metabolic information to be precisely overlapped with anatomical information, thereby improving the identification of sites with an abnormal accumulation of F-18 FDG. The role of FDG PET/CT in the therapeutic evaluation (such as in treatment planning, the therapeutic response, and the surveillance and examination of HNSCC patients) is discussed in this manuscript. When evaluating the post-treatment outcome via FDG PET/CT, it is important to exclude the post-treatment inflammation-related increase in glucose metabolism in lymph nodes, salivary gland, muscles, and soft tissues. The influence of inflammation can be eliminated if PET/CT is performed after 12 weeks, by which time post-treatment inflammation subsides. Further, FDG PET/CT affords a high negative predictive value. Based on the results of an FDG PET/CT test, some invasive tests that are performed to detect recurrence can be omitted.
18F-FDG PET/CT 已广泛用于诊断头颈部鳞状细胞癌（HNSCC）的原发肿瘤和淋巴结转移，并评估其对治疗的反应。使用 PET/CT 的优势在于，这种组合可以使代谢信息与解剖信息精确重叠，从而提高对 F-18 FDG 异常积聚部位的识别能力。本文讨论了 FDG PET/CT 在治疗评估（如治疗计划、治疗反应以及 HNSCC 患者的监测和检查）中的作用。在通过 FDG PET/CT 评估治疗后结果时，重要的是要排除治疗后淋巴结、唾液腺、肌肉和软组织中与炎症相关的葡萄糖代谢增加。如果在治疗后 12 周进行 PET/CT 检查，则可以消除炎症的影响，此时治疗后炎症消退。此外，FDG PET/CT 具有较高的阴性预测值。基于 FDG PET/CT 检测的结果，可以省略一些用于检测复发的有创检查。
