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OTORINOLARINGOLOGIA

A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery


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Otorinolaringologia 2009 September;59(3):141-55

language: English

The role of PET in head and neck cancer: more than 18FDG alone

Heuveling D. A., De Bree R., Van Dongen G. A. M. S.

1 Department of Otolaryngology / Head and Neck Surgery , VU University Medical Center, Amsterdam, The Netherlands
2 Department of Nuclear Medicine and PET Research, VU University Medical Center, Amsterdam, The Netherlands


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Positron emission tomography (PET) is a functional imaging modality that is widely used in oncology. The integration of PET with CT (PET/CT) has provided at the same time detailed morphological information, which is especially attractive for the anatomically complex head and neck region. In this overview, the more established role of 18FDG-PET in management of head and neck cancer is discussed, focusing on its pros and cons for staging of disease and for treatment response prediction and monitoring. 18FDG is not the ideal tracer for all these applications, and therefore several novel metabolic PET-tracers are presented. In addition, new fields of PET application are forecasted. Hypoxia is a common phenomenon in head and neck cancer and is associated with a poor response to (chemo)radiotherapy. Therefore, knowledge of hypoxia may influence treatment decisions. Several candidate hypoxia PET-tracers are discussed. With the increasing knowledge of critical molecular targets in head and neck cancer (e.g. the epidermal growth factor receptor), many novel targeted anticancer therapeutics become available among which monoclonal antibodies and tyrosin kinase inhibitors. Upon labeling of these drugs with a positron emitter, their distribution within the human body can be quantitatively imaged by PET. In this way, PET can be used for guidance of drug development and appropriate treatment selection for the individual patient (personalized medicine).

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