Head & Neck Cancer Case 02


Clinical History
60-year-old male with a history of left oropharyngeal carcinoma underwent chemotherapy, radiation therapy and brachytherapy. Two months after treatment a PET/CT scan was recommended for restaging.

Imaging Findings
NUCLEAR MEDICINE PET/CT
STATED REASON FOR REQUEST: Restaging left oropharyngeal carcinoma
TECHNIQUE: Emission scanning from the top of the skull through the abdomen was obtained approximately one hour post injection. Images were reconstructed with and without attenuation correction using the CT attenuation coefficients from the corresponding CT portion of the exam.
BLOOD GLUCOSE: 99 mg/dL

PET/CT FINDINGS
There was focal marked abnormal increased radiopharmaceutical uptake identified in the left oral cavity and parapharyngeal space which corresponded to soft tissue in this region on the CT scan.

There was no other abnormal uptake to suggest the presence of glucose avid malignancy.

Diagnosis
The PET/CT findings were highly suspicious for local recurrent malignancy in the left oral cavity and parapharyngeal space.

Treatment and Follow-Up
The patient was referred for further radiation treatment and was monitored with subsequent PET/CT scans.

Discussion
The use of PET/CT has been found to be very helpful, not only for the initial evaluation of patients for radiation therapy planning, but also in the follow-up of these patients after radiation treatment. PET/CT can help the physician identify areas of residual or recurrent tumor and detect areas that have failed therapy or identify new areas of involvement on follow-up imaging.

Data courtesy of Dr. Todd Blodgett, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

* Any of the protocols presented herein are for informational purposes and are not meant to substitute for clinician judgment in how best to use any medical devices. It is the clinician that makes all diagnostic determinations based upon education, learning and experience.