PET – Page 2 – 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|

Impact of PET scanning consistent across all cancer types

Source: www.medscape.com Authors: Zosia Chustecka, Désirée Lie, MD Scanning with positron emission tomography (PET) scanning has an impact on the intended management of patients with cancer in approximately one third of cases, and new data suggest that this impact is consistent across all cancer types. The results come from the National Oncologic PET Registry (NOPR), and the latest data are reported in the December issue of the Journal of Nuclear Medicine. "Although the effectiveness of PET may differ somewhat between individual cancers, it's in the same ballpark," says coauthor Barry Siegel, MD, professor of radiology at Mallinckrodt Institute of Radiology in St. Louis, Missouri. "This result was a little unexpected, but it leads us to believe that a continual parsing of PET's usefulness, cancer by cancer and indication by indication, for purposes of reimbursement does not make clinical sense." At present in the United States, the Centers for Medicare & Medicaid Services (CMS) restricts the reimbursement of PET scans for only 9 cancer types. The cancers that are covered include non–small-cell lung cancer, esophageal cancer, colorectal cancer, head and neck cancer, lymphoma and melanoma (all for diagnosis, staging, and restaging), breast cancer (for restaging and treatment monitoring), thyroid cancer (for restaging under very specific circumstances), and cervical cancer (for initial staging if conventional imaging result is negative for extrapelvic metastasis). NOPR was launched in 2006 in response to a proposal from the CMS to expand coverage for PET to other cancers. In this registry, patients are covered under the CMS [...]

Oral Cancer Foundation News Team - A2008-12-04T12:49:17-07:00December, 2008|Oral Cancer News|

Positron Emission Tomography Offers Modest Improvement for Staging of Head and Neck Cancers: Presented at AHNS

Source: Doctor's Guide (www.docguide.com) Author: Arushi Sinha Use of positron emission tomography (PET) imaging offers modest improvement in positive predictive value, specificity, and accuracy compared with computed tomography (CT) for diagnosing head and neck cancers. Researchers at the American Head and Neck Society 7th International Conference on Head and Neck Cancer (AHNS) presented new data on the effectiveness of PET scans singly or in combination with CT compared with CT scans alone. "We used the scans in comparison to the gold standard, which was the pathology findings from neck dissections," explained study presenter Surjeet Pohar, MD, Department of Radiation Oncology, Eastern Virginia Medical School, Norfolk, Virginia. The study, presented in a poster session on July 22, used information gathered from 36 patients diagnosed with head and neck squamous cell carcinoma. All the patients underwent neck dissection as well as CT scans, PET scans, or combined PET and CT. In addition, all patients received a full medical examination, endoscopy, and X-ray imaging to help stage their disease. In addition, nodal involvement and information about the side of the neck were also documented. As a result of the full diagnostic workup, the researchers found that most patients exhibited locally advanced disease: 4 patients had stage II disease; 3 had stage III disease; and 25 had stage IV disease. Four patients had indeterminate staging at the time of the initial workup. Results showed that several parameters of the different imaging technique were comparable. CT scans exhibited sensitivity to the samples in 72% of [...]

Oral Cancer Foundation News Team - A2008-07-25T03:02:48-07:00July, 2008|Oral Cancer News|