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Clinical impact of positron emission tomography (PET) with (18F)fluorodeoxyglucose (FDG) in head and neck tumours
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Oncology.
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2007 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, Vol. 127, no 2, 186-193 p.Article in journal (Refereed) Published
Abstract [en]

Conclusion. PET plays an important role in staging, on suspicion of recurrence and for detection of occult primary tumours in the head and neck. Objective: Since 1998 we have used positron emission tomography (PET) with (F-18)fluorodeoxyglucose (FDG) to assess selected patients. This procedure has often helped in making decisions on staging and treatment. Patients and methods. The case records of the first 80 patients (104 PET examinations) were studied retrospectively. Results. A total of 39 examinations were performed for staging. PET detected all primary tumours except two (stage T1), and staging was adjusted after 13%. In all, 33 PET examinations were performed on suspicion of recurrent tumour. In 52% of these PET determined further treatments; in 21% PET had a direct impact on the surgical planning. In 18 patients with metastases from an occult primary tumour, PET detected 39% of those tumours; in 22% it was the sole modality to do so. No recurrences or second primary tumours were detected when PET was used for follow-up of clinically cured patients. Results were similar when squamous cell carcinomas (SCCs) were considered alone as compared to the complete material. The mean standardized uptake value (SUV) was higher for cases deemed tumour-positive than in negative cases.

Place, publisher, year, edition, pages
2007. Vol. 127, no 2, 186-193 p.
Keyword [en]
PET, FDG, head and neck, tumour, recurrence
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96592DOI: 10.1080/00016480600801407ISI: 000244752000011PubMedID: 17364351OAI: oai:DiVA.org:uu-96592DiVA: diva2:171222
Available from: 2008-01-04 Created: 2008-01-04 Last updated: 2012-03-06Bibliographically approved
In thesis
1. Diagnosis and Radioimmunotherapy of Head and Neck Squamous Cell Carcinomas
Open this publication in new window or tab >>Diagnosis and Radioimmunotherapy of Head and Neck Squamous Cell Carcinomas
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The diagnosis and treatment of patients with advanced tumors in the head and neck is an interesting challenge where there is a need for new approaches in diagnostics and adjuvant treatment. Differences in antigen expression between tumors and normal tissues provide a means for application of antibody-based targeting techniques. By targeting a structure that is abundant on tumor cells and limited on normal cells, radioactivity can be delivered.

The use of positron emission tomography (PET) in patients with head and neck tumors is evaluated in this thesis. PET using the tracer fluorodeoxyglucose (FDG) is found to play an important diagnostic role and often has a direct clinical impact on planned surgery or other treatment. Possible targeting structures are also investigated in this thesis, and it is concluded that the EGFR and CD44v6 stand out as possible antigens for targeting approaches of squamous cell carcinomas in the head and neck (HNSCC). A radioimmunoassay for quantification of EGFR and CD44v6 is validated and concluded to be a valuable complement to immunohistochemistry for the analysis of tumors and for the planning of radioimmunotherapy. Finally, promising results of radioimmunotherapy in tumor bearing mice with the monoclonal antibody U36 labeled with the alpha emitter astatine-211 are presented.

These results demonstrate how differences between tumors and normal tissues can be used to improve diagnostic outcomes and indicate that radioimmunotherapy can be a future adjuvant therapy or treatment of residual disease in HNSCC.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 49 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 300
Keyword
Otorhinolaryngology, head and neck squamous cell carcinoma, tumor targeting, radionuclide targeting, PET, therapy, diagnistics, antibodies, Otorhinolaryngologi
Identifiers
urn:nbn:se:uu:diva-8395 (URN)978-91-554-7060-9 (ISBN)
Public defence
2008-01-26, Skoogsalen, Ingång 78/79, Akademiska Sjukhuset, 751 85 Uppsala, 13:00
Opponent
Supervisors
Available from: 2008-01-04 Created: 2008-01-04Bibliographically approved

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