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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
Bertagna F. 1, Biasiotto G. 2, Rodella C. A. 3, Savelli G. 1, Bosio G. 1, Giubbini R. 1
1 Department of Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
2 Department of Maternal, Infant and Biomedical Technologies, University of Brescia, Italy
3 Health Physics Unit, Spedali Civili Brescia, Brescia, Italy
Head and neck cancers, most of which are squamous cell carcinomas, involve all regions of the head and neck, excluding the thyroid and central nervous system, and are usually classified into five groups according to regional anatomy location: oral cavity, larynx, rhinopharynx, oropharynx, hypopharynx. Early stage head and neck tumours are treated by surgery or radiotherapy, whereas locally advanced ones are treated by combined surgery and chemo/radiotherapy. The prognosis of patients with distant metastases, which are most commonly seen in the lungs, bone and liver, is very poor and treatment is palliative with chemotherapy or radiotherapy. Ultrasound, computed tomography (CT) and magnetic resonance imaging are pivotal diagnostic tools in head and neck cancer evaluation, providing accurate anatomical information also regarding organ infiltration and extension. Positron emission tomography (PET)/CT with F18-FDG and amino acids labelled with positron emitters (C11-TYR, C11-MET) is a feasible, useful and accurate tool in evaluating head and neck cancers, particularly of the pharynx and of the larynx. The most useful results allowing a change in management of restaging are seen in the differentiation between residual or persistent diseases after chemotherapy or radiotherapy. Tumor stage could be more accurately determined using F18-FDG-PET/CT, in particular in lymph node evaluation (and more for those of less than 1 cm). Conformal radiotherapy (3D-CRT) and intensity modulated radiation therapy are significantly modified by F18-FDG-PET/CT in volume delineations.