J Nucl Med. 2008; 49 (Supplement 1):179P
Educational Exhibits (Poster Only)
The role of PET/CT in the management of laryngeal cancer
Jongdae Suh3 and
1 Radiology, University of Maryland Medical Center, Baltimore, Maryland;
2 Radiology, VA Maryland Healthcare System, Baltimore, Maryland;
3 Radiology, SUNY Downstate Medical Center, Brooklyn, New York
Learning Objectives: 1. Describe the management of laryngeal cancer. 2. Describe the role of PET/CT in the management of laryngeal cancer.
Abstract Body: Laryngeal cancer is the most common tumor in the head and neck causing death. This malignancy is usually a squamous cell carcinoma which is highly FDG avid. Therefore PET imaging with FDG is sensitive in detecting the presence of this type of malignancy. The addition of fusion with CT increases the accuracy of the imaging. The initial management of the head and neck cancer patient involves a physical exam with panendoscopy and biopsy. At times squamous cell carcinoma involves cervical lymph nodes without a primary lesion found after convention imaging with CT or MR. PET/CT is able to locate the primary in 25% of these cases. PET/CT has proved superior to CT and MR in initial staging in the detection of lymph node metastatic disease. The sensitivity and specificity for PET/CT are 80% and 90% whereas for CT and MR these values are 60% and 70%. PET/CT may also locate distant metastatic disease or a synchronous primary malignancy. The treatment of laryngeal cancer is primarily surgery and/or radiation therapy. After treatment, the head and neck anatomy is distorted by surgery and/or radiation, and the distinction between post-treatment changes and residual tumor is difficult with conventional imaging. However, PET/CT with the addition of functional imaging to CT has higher overall diagnostic accuracy then conventional imaging alone. Accuracy is improved when PET/CT imaging is done 6 weeks after chemoradiation or more ideally 12 weeks after radiation therapy. Examples of the role of PET/CT in the management of laryngeal cancer are provided.