CT – Oral Cancer News

‘Paradoxical’ data show routine imaging lacks benefit for head and neck cancer survivors

Source: www.healio.com Author: Matthew Shinkle Key takeaways: Researchers saw no statistical difference between patient groups with respect to treatment outcomes. Larger studies are needed to further evaluate this study’s findings. Compared with expectant management, imaging-based surveillance did not improve outcomes among patients in remission after completion of primary radiation therapy for head and neck cancer, according to data published in JAMA Network Open. Although imaging “in the context of clinical suspicion” for this specific patient population is common and typically beneficial, according to researchers, the results of this study show that such a practice is not valuable for asymptomatic patients. “The results of the present study, while seemingly paradoxical, are consistent with those of others which have failed to demonstrate a benefit to surveillance imaging among patients who have successfully completed treatment for head and neck cancer,” Allen M. Chen, MD, MBA, professor and chair of the department of radiation oncology at University of California, Irvine, Chao Family Comprehensive Cancer Center, and researchers wrote. Researchers conducted a retrospective, comparative effectiveness review to evaluate the potential benefit of surveillance imaging among asymptomatic patients with head and neck cancer currently in remission following completion of chemoradiation. The study included 340 adults (59% men; 43% white) who had achieved a complete metabolic response to initial treatment for newly diagnosed squamous cell carcinoma of the head and neck between January 2014 and June 2022. Researchers defined surveillance imaging as the acquisition of a PET with CT, MRI or CT of the head and neck [...]

Oral Cancer Foundation News Team - A2024-03-14T16:33:37-07:00March, 2024|Oral Cancer News|

Head and neck cancer: Getting a diagnosis of head and neck cancer

Source: www.curetoday.com Author: staff Meryl Kaufman, M.Ed., CCC-SLP, BRS-S, and Itzhak Brook, M.D., M.Sc., board members of the Head and Neck Cancer Alliance, discuss which symptoms should lead one to seek a diagnosis of head and neck cancer and which tests are available to aid in evaluation. Transcript: Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: When we talk about the HPV-related cancers, those are primarily in the oropharynx, which is the tongue base and the tonsil. But the traditional cancers typically can also involve the tongue, the lips, the floor of the mouth, the jaw, the gums and the hard palate. And the pharynx; that includes the nasopharynx behind the nose. We’ve addressed the oropharynx but also the hypopharynx, near the larynx. And in your case, laryngeal cancer that involves the larynx, the voice box, and the epiglottis. So, head and neck cancers can occur in any of those places. Can you talk about some of the signs and symptoms people can look out for in those areas? Itzhak Brook, M.D., M.Sc.: Well, the important signs that are common to oral cancers are having a sore throat, a feeling that you cannot swallow and difficulty in swallowing. In advanced stages, it can interfere with breathing. If you have increased lymph glands in the neck and are also feeling like a lump or something is stuck in your mouth, those could be a sign. Sometimes they have symptoms such as pain in the ear or pain in the throat. And there are specific [...]

Oral Cancer Foundation News Team - A2018-09-04T13:05:12-07:00September, 2018|Oral Cancer News|

Nonsurgical surveillance safe, cost-effective for head, neck cancer

Source: www.healio.com Author: Mehanna H, et al. Patients with head and neck cancer who underwent PET/CT–guided surveillance achieved similar survival outcomes as those who underwent planned neck dissections, according to the results of a prospective, randomized controlled trial. However, surveillance led to fewer surgical operations and complications and appeared more cost-effective than neck dissection, results showed. Patients with head and neck cancer frequently undergo invasive surgery following treatment to remove remaining cancer cells, according to study background. “After treatment, remaining cancer cells play something akin to hide and seek,” Hisham Mehanna, MBChB, PhD, FRCS, chair of head and neck surgery at University of Birmingham and director of the Institute of Head and Neck Studies and Education, said in a press release. “Our study shows that we can hunt them down, find them and remove them effectively.” Mehanna and colleagues sought to define the role of image-guided surveillance compared with planned neck dissection for the management of patients with advanced, nodal head and neck squamous cell carcinoma previously treated with primary chemoradiotherapy. The analysis included data from 564 patients (mean age, 58 years; 82% men) who researchers randomly assigned to PET/CT–guided surveillance (n = 282) performed 12 weeks after the end of treatment or planned neck dissection (n = 282). Oropharyngeal cancer served as the most common cancer subtype (84%). Seventy-five percent of patients had HPV-16–positive disease. Patients assigned surveillance only underwent neck dissection if their PET/CT scans showed incomplete or equivocal response to chemoradiotherapy. The trial was designed to assess [...]

Oral Cancer Foundation News Team - A2016-03-24T09:07:04-07:00March, 2016|Oral Cancer News|

Imaging method has potential to stratify head and neck cancer patients

Source: www.eurekalert.org Author: press release Manchester researchers have identified a potential new way to predict which patients with head and neck cancer may benefit most from chemotherapy. These patients commonly receive pre-treatment induction chemotherapy, before either surgery or radiotherapy, to reduce the risk of disease spread. However the effectiveness of such treatment is reduced in tumours with poor blood flow. Previous studies have shown that CT scans can be used to assess tumour blood flow. Now researchers at The University of Manchester and The Christie NHS Foundation Trust - both part of the Manchester Cancer Research Centre - have explored the use of MRI scans in predicting which patients would benefit from induction chemotherapy. Professor Catharine West, who led the study, said: "It's also important to identify those patients who are unlikely to respond to induction therapy so that we can skip ahead in the treatment pathway and offer them potentially more effective treatments and hopefully improve their outcome." The team used an imaging technique known as dynamic contrast-enhanced MRI (DCE-MRI), where a contrast agent tracer is injected into a patient's vein whilst they have a series of MRI scans taken. This allows scientists and doctors to investigate the blood flow and vessel structure of a patient's tumour. They found that the blood flow of a patient's tumour before they received induction therapy could predict response to treatment. In a paper recently published in the journal Oral Oncology, the group report that those with high tumour blood flow were more [...]

Oral Cancer Foundation News Team - A2015-09-19T08:39:53-07:00September, 2015|Oral Cancer News|

UK researchers improve comfort levels for cancer patients by 3D printing radiotherapy body molds

Source: 3dprint.com Author: Bridget Butler Millsaps Cancer patients undergoing brain or head and neck radiotherapy are required to be immobilized, which is certainly not always popular with those undergoing the procedure, who may already be suffering from anxiety. To make things worse, in order to be immobilized completely during the procedure, it is crucial that they are wearing a fitted mold to prevent motion. Having the mold made is a whole process in itself before the procedure can begin. In a recent study produced by the Journal of Radiotherapy in Practice, over half of the patients describe the process of having a mold made as ‘horrific.’ Many of them also described the process as ‘uncomfortable.’ Topping that off with molded shells that quite often do not fit appropriately, the anxiety levels are heightened for patients — enough so that researchers centered their study around the creation of molded shells through 3D printing that could be created from data conveniently already existing in the form of a CT scan. The process would increase the comfort level for the patient and save a great deal of time in preparing a molding. Radiotherapy is a type of cancer treatment which uses high-energy rays to zap cancer cells. The procedure has to be precisely aimed directly at specific areas to have effect, and it’s not a procedure anyone wants immediately repeated; therefore, It’s important to have the head shell or molding during radiotherapy because the patient must lie still. The mold or shell holds the [...]

Oral Cancer Foundation News Team - A2014-11-12T06:54:21-07:00November, 2014|Oral Cancer News|

MRI can show jaw invasion of oral cancer

Source: www.medpagetoday.com Author: Charles Bankhead, Staff Writer Oral cancer's spread to the mandible could not hide from a type of MRI that may facilitate more accurate staging and surgical planning, data from laboratory studies suggest. Sweep imaging with Fourier transform (SWIFT) provided fine-detail views of cortical and medullary bone specimens, and the images exhibited good correlation with histopathologic findings. The in-vitro studies did not specifically examine SWIFT's ability to identify early cortical bone invasion by oral cancer. However, the high-quality images obtained from the investigation provide reason for optimism, the researchers reported in the September issue of Archives of Otolaryngology Head and Neck Surgery. "Our study is very promising in that it offers a SWIFT-based MRI technique for accurate assessment of minute changes of cortical and medullary bone in three dimensions without any ionizing radiation," Ayse Tuba Karagulle Kendi, MD, of the University of Minnesota in Minneapolis, and co-authors wrote. "It has the potential to precisely determine the extent of mandibular bone invasion associated with oral carcinoma. This study is a crucial step toward the goal of developing a robust and noninvasive approach for preoperative imaging of mandibular invasion," they added. Carcinoma of the oral cavity often spreads to the mandible, but in many instances does not cross the periosteal layer, obviating the need for mandibulectomy. Limitations of current imaging techniques often preclude determination of bone invasion prior to surgery, the authors noted. MRI and CT have been used most often to evaluate mandibular invasion of oral cancer, but conventional [...]

Oral Cancer Foundation News Team - A2011-09-23T16:35:59-07:00September, 2011|Oral Cancer News|

Ultrasound as effective as CT scans for most diagnoses, reducing the dangers of radiation

Source: www.medicalnewstoday.com Author: staff For diagnosing head and neck ailments, tests that use radiation are always less desirable than those that don't. Otolaryngologists have a wide range of techniques available to them, including CT or "CAT" scans, MRI and ultrasound. CT uses significant radiation and MRI a lower amount, but ultrasound is a non-invasive, non-radiating technique. It does not require injection of radioactive contrast material and has no side effects. Now, a new study by Tel Aviv University exploring the efficacy of expensive and invasive CT scans has found that, in some cases, they don't offer a clinical advantage over a simple, inexpensive ultrasound procedure. In his study, Dr. Michael Vaiman of Tel Aviv University's Sackler Faculty of Medicine compared the efficacy of CT versus ultrasound scans for locating vertebral arteries in the throat, an important assessment that must be completed before a surgeon operates in the neck area of the body. After comparing the outcomes of 250 CT scans with 500 ultrasound images, he concluded that there is no advantage to using CT scans for most of these procedures, especially those that are used to locate anomalies in the neck to map major arteries before surgery can take place. Dr. Vaiman's results were published in the March issue of the European Archives of Oto-Rhino-Laryngology. When scans are sound CT scans combine X-rays with highly sophisticated computers to produce a number of pictures of the interior of the body. Traditionally, doctors have relied on these scans to find neck arteries [...]

Oral Cancer Foundation News Team - A2011-05-13T12:21:24-07:00May, 2011|Oral Cancer News|

Combined CT, FDG-PET improves head/neck cancer treatments

Source: www.drbicuspid.com Author: staff Combining CT with fluorodeoxyglucose positron emission tomography (FDG-PET) imaging results in significantly more defined tumor outlines and potentially different treatment options in head and neck cancer patients compared with using CT alone, according to research presented April 29 at the Cancer Imaging and Radiation Therapy Symposium in Atlanta. In this trial, conducted at Utrecht University Medical Center, 327 patients were treated with intensity-modulated radiation therapy for head and neck cancer. Based on the combined approach of the CT scan and FDG-PET, the researchers noticed a change in the delineation of the tumor in one out of three patients, resulting in 10% of patients' treatment being changed and 33% of patients having their treatment adjusted. In 17% of the patients, the primary tumor was not visible on the CT scan alone, mostly due to dental inlays. "We expected there to be an improved delineation of the tumor," said Homan Dehnad, MD, study author and radiation oncologist at Utrecht University Medical Center. "However, we never expected it to have such an influence on the treatment options for patients. Each dedicated institute dealing with head and neck cancer should be equipped with multi-imaged facilities."

Oral Cancer Foundation News Team - A2011-04-30T15:34:38-07:00April, 2011|Oral Cancer News|

Journal of Nuclear Medicine: 18F-FDG PET+CT cost-effective in screening head and neck cancer patients

Source: www.healthimaging.com Author: staff Whole-body 18F-FDG PET combined with chest CT is cost-effective in pretreatment screening for distant metastases in head and neck squamous cell carcinoma (HNSCC) patients with risk factors, according to a study published in the February issue of the Journal of Nuclear Medicine. The presence of distant metastases at initial evaluation influences the prognosis and the treatment choice in HNSCC patients and hybrid PET/CT scanners was superior in sensitivity and cost effective when compared to FDG PET and CT alone, according to Otto S. Hoekstra, MD, PhD, of the VU University Medical Center in Amsterdam. In the study, 145 patients underwent chest CT and whole-body 18F-FDG PET for screening of distant metastases. The researchers analyzed the cost data of 80 patients in whom distant metastases developed or who had a follow-up of at least 12 months. Hoekstra said that cost-effectiveness analysis, including sensitivity analysis, was performed to compare the results of 18F-FDG PET, CT and a combination of CT and 18F-FDG PET. Hoekstra and colleagues identified distant metastases in 21 percent of patients by pretreatment screening. According to Hoekstra and colleagues, CT plus 18F-FDG PET had the highest sensitivity of 63 percent, while 18F-FDG PET had a sensitivity of 53 percent versus 37 percent with CTand positive predictive value of 80 percent versus 75 percent with CT. “CT + 18F-FDG PET resulted in savings between €203 ($303) and €604 ($903) ”, wrote Hoekstra and colleagues. The average costs in the CT + 18F-FDG PET group was found [...]

Oral Cancer Foundation News Team - A2010-02-23T12:55:19-07:00February, 2010|Oral Cancer News|

PET-FDG improves staging, management of head, neck cancer

Source: helathimaging.com Author: staff Adding whole-body PET-FDG to the pre-therapeutic conventional staging of head and neck squamous cell carcinoma improved the TNM [tumor, node and metastasis] classification of the disease and altered the management of 13.7 percent of patients, according to a study published in the February issue of the Journal of Clinical Oncology. Max Lonneux, MD, from the departments of nuclear medicine, head and neck surgery, radiation oncology and maxillofacial surgery, Cliniques Universitaires Saint-Luc in Brussels, and colleagues included his 233 patients in this multicenter, prospective study with newly diagnosed and untreated head and neck squamous cell carcinoma. Researchers first determined the TNM stage and therapeutic decision based on the conventional work-up (including physical exam, CT/MRI of the head and neck region, and thoracic CT) and sealed in envelope. They then performed whole-body PET-FDG, and subsequently wrote TNM stage and therapeutic decision in a sealed envelope. The investigators also recorded changes in TNM stages and in patient management as a result of PET-FDG imaging. Clinical outcome and histopathology were used as gold standards to validate the TNM stage. Conventional and PET stages were compared using the McNemar test. According to the authors, conventional and PET stages were discordant in 43 percent of the patients. PET proved to be accurate in 47 patients and inaccurate in 13 patients. TNM status was left unconfirmed in 40 patients because no therapeutic change was expected from the stage difference. The researchers found that conventional plus PET TNM classification (envelope two) was significantly more [...]

Oral Cancer Foundation News Team - A2010-02-17T08:18:31-07:00February, 2010|Oral Cancer News|