Van den Wyngaert Tim, De Schepper Stijn, Carp Laurens
Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium.
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Front Oncol. 2020 Aug 14;10:1458. doi: 10.3389/fonc.2020.01458. eCollection 2020.
2-deoxy-2-[F]fluoro-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is indicated in head-and-neck cancer for the initial workup when clinically indicated (e. g., large tumors, clinically positive neck, cervical adenopathy from an unknown primary, etc.), for the assessment of treatment response 12 weeks after completion of (chemo)radiotherapy, and during follow-up when there is suspicion of relapse. The successful implementation of FDG-PET/CT in routine clinical practice requires an in-depth understanding of the recent advances in physics and engineering that have significantly improved the imaging capabilities of PET/CT scanners (e.g., digital silicon photomultipliers, point-spread function modeling, and time-of-flight, and Bayesian penalized likelihood reconstruction). Moreover, a coordinated harmonization effort from professional societies (e.g., EANM) and international bodies (e.g., IAEA) has resulted in the creation of quality assurance frameworks (e.g., QUANUM, EARL, GMP) and guidelines that collectively cover the entire spectrum from tracer production, hardware calibration, patient preparation, and scan acquisition, to image interpretation (e.g., PERCIST, Hopkins criteria). The ultimate goal is to standardize the PET/CT technique and to guarantee accurate and reproducible imaging results for every patient. This review summarizes the recent technical breakthroughs in PET/CT scan design and describes the existing quality assessment frameworks with a focus on applications in head-and-neck cancer. Strict adherence to these harmonization efforts will enable leveraging the full potential of PET/CT and translate the proven benefits of this technique into tangible improvements in outcome for patients with head-and-neck cancer in routine clinical care.
2-脱氧-2-[F]氟-D-葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）适用于头颈部癌，用于临床指征明确时的初始检查（如大肿瘤、临床颈部阳性、原发灶不明的颈部淋巴结病等）、完成（化疗）放疗12周后评估治疗反应以及随访期间怀疑复发时。要在常规临床实践中成功应用FDG-PET/CT，需要深入了解物理学和工程学的最新进展，这些进展显著提高了PET/CT扫描仪的成像能力（如数字硅光电倍增管、点扩散函数建模、飞行时间以及贝叶斯惩罚似然重建）。此外，专业协会（如欧洲核医学协会）和国际机构（如国际原子能机构）的协同协调努力促成了质量保证框架（如QUANUM、EARL、GMP）和指南的制定，这些框架和指南共同涵盖了从示踪剂生产、硬件校准、患者准备、扫描采集到图像解读（如PERCIST、霍普金斯标准）的全过程。最终目标是使PET/CT技术标准化，并确保为每位患者提供准确且可重复的成像结果。本综述总结了PET/CT扫描设计的最新技术突破，并描述了现有的质量评估框架，重点关注在头颈部癌中的应用。严格遵循这些协调努力将能够充分发挥PET/CT的潜力，并将该技术已证实的益处转化为常规临床护理中头颈部癌患者预后的切实改善。
