Utility of TL-201 SPECT in clarifying false-positive FDG-PET findings due to osteoradionecrosis in head and neck cancer

Background This study aimed to determine whether Tl‐201 single photon emission CT (SPECT) is potentially useful in differentiating false‐positive fluorodeoxyglucose positron emission tomography (FDG‐PET) findings caused by osteoradionecrosis (ORN) from recurrent head and neck cancer after radiothera...

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Bibliographic Details
Published in:Head & neck 2010-12, Vol.32 (12), p.1648-1654
Main Authors: Wang, Chih-Hsiu, Liang, Ji-An, Ding, Hueisch-Jy, Yang, Shih-Neng, Yen, Kuo-Yang, Sun, Shung-Shung, Kao, Chia-Hung
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cancer
Diagnosis, Differential
Diseases of the osteoarticular system
False Positive Reactions
FDG-PET
Female
Fluorodeoxyglucose F18
Head
Head and neck cancer
Humans
Male
Medical sciences
Middle Aged
Neck
Neoplasm Recurrence, Local
Osteoradionecrosis
Osteoradionecrosis - diagnostic imaging
Otorhinolaryngologic Neoplasms - diagnostic imaging
Otorhinolaryngologic Neoplasms - radiotherapy
Otorhinolaryngology (head neck, general aspects and miscellaneous)
Otorhinolaryngology. Stomatology
Positron emission tomography
Radiopharmaceuticals
Radiotherapy
Single photon emission computed tomography
SPECT
Thallium Radioisotopes
Tl-201
Tomography, Emission-Computed, Single-Photon
Tumors
Vascular bone diseases
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Summary:Background This study aimed to determine whether Tl‐201 single photon emission CT (SPECT) is potentially useful in differentiating false‐positive fluorodeoxyglucose positron emission tomography (FDG‐PET) findings caused by osteoradionecrosis (ORN) from recurrent head and neck cancer after radiotherapy. Methods Five patients were recruited. Dual‐phase FDG‐PET and dual‐phase Tl‐201 SPECT were performed for each patient. Results All 5 patients proved to have ORN without recurrent cancer. By visual interpretation, the results were 4 positive versus 1 negative for PET, and 4 negative versus 1 positive for Tl‐201 SPECT. The Tl‐201 SPECT clarified 3 of the 4 false‐positive PETs to be ORN. Dual‐phase semiquantitative studies showed decreased standardized uptake value (SUV) over time in 3 of the 4 false‐positive PETs and decreased lesion/background ratio over time in the false‐positive Tl‐201 SPECT. Conclusion The Tl‐201 SPECT may help clarify suspected false‐positive FDG uptake caused by ORN. Dual‐phase FDG‐PET and dual‐phase Tl‐201 SPECT may also have some value. © 2010 Wiley Periodicals, Inc. Head Neck, 2010
ISSN:1043-3074
1097-0347
1097-0347
DOI:10.1002/hed.21377