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

Dominic Raphael Schwaninger, Martin Hüllner, Dominique Bichsel, Barbara Giacomelli-Hiestand, Nicole Selina Stutzmann, Panagiotis Balermpas, Silvio Valdec, Bernd Stadlinger
2022
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-glucosepositron 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
more » ... 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 (SUV max ) 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 maxillomandibular 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.
doi:10.5167/uzh-220757 fatcat:i5ps7neuobbw5ffa3ng7lexvbe