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FDG-PET/CT for oral focus assessment in head and neck cancer patients


Schwaninger, Dominic Raphael. FDG-PET/CT for oral focus assessment in head and neck cancer patients. 2022, University of Zurich, Faculty of Medicine.

Abstract

Objectives: To compare oral and maxillo-mandibular inflammatory foci on standard oral radiographs (OPT, periapical radiograph) with available fluorine-18-labelled fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) data and to discuss whether additional metabolic information derived from FDG-PET/CT can support oral care specialists when performing oral focus examinations.

Materials and methods: Data from 23 patients with head and neck cancer who underwent FDG-PET/CT and panoramic and periapical radiography in close succession before first-line radiotherapy and/or chemotherapy were included in this exploratory retrospective study. Periapical lesions and marginal periodontal inflammation on FDG-PET/CT scans and standard oral radiographs were analysed and compared with regard to metabolic activity on FDG-PET/CT in comparison to recorded clinical symptoms and radiological scores. Additionally, inflammatory maxillo-mandibular pathologies were analysed using FDG-PET/CT.

Results: The maximum standardised uptake value (SUVmax) in FDG-avid marginal periodontal sites could not be conclusively associated with the radiologically recorded severity of marginal bone loss, but a potential positive correlation was identified. No association was found either between the metabolic activity of periapical lesions and their extent, as recorded on standard oral radiographs, or regarding clinical symptoms (percussion test). Most maxillo-mandibular pathologies did not show increased FDG uptake.

Conclusions: FDG-PET/CT provided additional metabolic information that can help clinicians identify lesions with increased inflammatory activity. The incorporation of available oral FDG-PET/CT findings into the primary oral focus assessment may allow for more accurate oral focus treatment.

Clinical relevance: FDG-PET/CT provides valuable metabolic information for oral care specialists. The detection of inflammatory oral processes using FDG-PET/CT facilitates treatment.

Keywords: Head and neck cancer; Oral focus; Panoramic radiography; Periapical radiography; Positron emission tomography–computed tomography; Radiochemotherapy

Abstract

Objectives: To compare oral and maxillo-mandibular inflammatory foci on standard oral radiographs (OPT, periapical radiograph) with available fluorine-18-labelled fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) data and to discuss whether additional metabolic information derived from FDG-PET/CT can support oral care specialists when performing oral focus examinations.

Materials and methods: Data from 23 patients with head and neck cancer who underwent FDG-PET/CT and panoramic and periapical radiography in close succession before first-line radiotherapy and/or chemotherapy were included in this exploratory retrospective study. Periapical lesions and marginal periodontal inflammation on FDG-PET/CT scans and standard oral radiographs were analysed and compared with regard to metabolic activity on FDG-PET/CT in comparison to recorded clinical symptoms and radiological scores. Additionally, inflammatory maxillo-mandibular pathologies were analysed using FDG-PET/CT.

Results: The maximum standardised uptake value (SUVmax) in FDG-avid marginal periodontal sites could not be conclusively associated with the radiologically recorded severity of marginal bone loss, but a potential positive correlation was identified. No association was found either between the metabolic activity of periapical lesions and their extent, as recorded on standard oral radiographs, or regarding clinical symptoms (percussion test). Most maxillo-mandibular pathologies did not show increased FDG uptake.

Conclusions: FDG-PET/CT provided additional metabolic information that can help clinicians identify lesions with increased inflammatory activity. The incorporation of available oral FDG-PET/CT findings into the primary oral focus assessment may allow for more accurate oral focus treatment.

Clinical relevance: FDG-PET/CT provides valuable metabolic information for oral care specialists. The detection of inflammatory oral processes using FDG-PET/CT facilitates treatment.

Keywords: Head and neck cancer; Oral focus; Panoramic radiography; Periapical radiography; Positron emission tomography–computed tomography; Radiochemotherapy

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Additional indexing

Item Type:Dissertation (monographical)
Referees:Attin Thomas, Stadlinger Bernd
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Conservative and Preventive Dentistry
04 Faculty of Medicine > Center for Dental Medicine > Clinic of Reconstructive Dentistry
04 Faculty of Medicine > Center for Dental Medicine > Clinic of Cranio-Maxillofacial Surgery
UZH Dissertations
Dewey Decimal Classification:610 Medicine & health
Language:English
Place of Publication:Zürich
Date:2022
Deposited On:20 Oct 2022 10:48
Last Modified:24 Mar 2023 04:34
OA Status:Closed
Free access at:Related URL. An embargo period may apply.
Related URLs:https://www.zora.uzh.ch/id/eprint/220757/ (Organisation)
https://pubmed.ncbi.nlm.nih.gov/35254526/ (Organisation)
https://link.springer.com/article/10.1007/s00784-022-04403-2 (Publisher)
https://uzb.swisscovery.slsp.ch/permalink/41SLSP_UZB/7tnetr/alma99117280455105508 (Library Catalogue)
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