Distinguishing tumor recurrence from irradiation sequelae with positron emission tomography in patients treated for larynx cancer
Purpose : Distinguishing persistent or recurrent tumor from postradiation edema, or soft tissue/cartilage necrosis in patients treated for carcinoma of the larynx can be difficult. Because recurrent tumor is often submucosal, multiple deep biopsies may be necessary before a diagnosis can be establis...
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| Veröffentlicht in: | International Journal of Radiation Oncology, Biology and Physics Biology and Physics, 1994-07, Vol.29 (4), p.841-845 |
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| creator | Greven, Kathryn M. Williams, Daniel W. Keyes, John W. McGuirt, W.Fred Harkness, Beth A. Watson, Nat E. Raben, Milton Frazier, Lisa C. Geisinger, Kim R. Cappellari, James O. |
| description | Purpose
: Distinguishing persistent or recurrent tumor from postradiation edema, or soft tissue/cartilage necrosis in patients treated for carcinoma of the larynx can be difficult. Because recurrent tumor is often submucosal, multiple deep biopsies may be necessary before a diagnosis can be established. Positron emission tomography with 18F-2fluoro-2deoxyglucose (FDG) was studied for its ability to aid in this problem.
Methods and Materials
: Positron emission tomography (18FDG) scans were performed on 11 patients who were suspected of having persistent or recurrent tumor after radiation treatment for carcinoma of the larynx. Patients underwent thorough history and physical examinations, scans with computerized tomography, and pathologic evaluation when indicated. Standard uptake values were used to quantitate the FDG uptake in the larynx.
Results
: The time between completion of radiation treatment and positron emission tomography examination ranged from 2 to 26 months with a median of 6 months. Ten patients underwent computed tomography (CT) of the larynx, which revealed edema of the larynx (six patients), glottic mass (four patients), and cervical nodes (one patient). Positron emission tomography scans revealed increased FDG uptake in the larynx in five patients and laryngectomy confirmed the presence of carcinoma in these patients. Five patients had positron emission tomography results consistent with normal tissue changes in the larynx, and one patient had increased FDG uptake in neck nodes. This patient underwent laryngectomy, and no cancer was found in the primary site, but nodes were pathologically positive. One patient had slightly elevated FDG uptake and negative biopsy results. The remaining patients have been followed for 11 to 14 months since their positron emission studies and their examinations have remained stable. In patients without tumor, average standard uptake values of the larynx ranged from 2.4 to 4.7, and in patients with tumor, the range was 4.9 to 10.7.
Conclusion
: Positron emission tomography with labeled FDG appears to be useful in distinguishing benign from malignant changes in the larynx after radiation treatment. This noninvasive technique may be preferable to biopsy, which could traumatize radiation-damaged tissues and precipitate necrosis. |
| doi_str_mv | 10.1016/0360-3016(94)90574-6 |
| format | Article |
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: Distinguishing persistent or recurrent tumor from postradiation edema, or soft tissue/cartilage necrosis in patients treated for carcinoma of the larynx can be difficult. Because recurrent tumor is often submucosal, multiple deep biopsies may be necessary before a diagnosis can be established. Positron emission tomography with 18F-2fluoro-2deoxyglucose (FDG) was studied for its ability to aid in this problem.
Methods and Materials
: Positron emission tomography (18FDG) scans were performed on 11 patients who were suspected of having persistent or recurrent tumor after radiation treatment for carcinoma of the larynx. Patients underwent thorough history and physical examinations, scans with computerized tomography, and pathologic evaluation when indicated. Standard uptake values were used to quantitate the FDG uptake in the larynx.
Results
: The time between completion of radiation treatment and positron emission tomography examination ranged from 2 to 26 months with a median of 6 months. Ten patients underwent computed tomography (CT) of the larynx, which revealed edema of the larynx (six patients), glottic mass (four patients), and cervical nodes (one patient). Positron emission tomography scans revealed increased FDG uptake in the larynx in five patients and laryngectomy confirmed the presence of carcinoma in these patients. Five patients had positron emission tomography results consistent with normal tissue changes in the larynx, and one patient had increased FDG uptake in neck nodes. This patient underwent laryngectomy, and no cancer was found in the primary site, but nodes were pathologically positive. One patient had slightly elevated FDG uptake and negative biopsy results. The remaining patients have been followed for 11 to 14 months since their positron emission studies and their examinations have remained stable. In patients without tumor, average standard uptake values of the larynx ranged from 2.4 to 4.7, and in patients with tumor, the range was 4.9 to 10.7.
Conclusion
: Positron emission tomography with labeled FDG appears to be useful in distinguishing benign from malignant changes in the larynx after radiation treatment. This noninvasive technique may be preferable to biopsy, which could traumatize radiation-damaged tissues and precipitate necrosis.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/0360-3016(94)90574-6</identifier><identifier>PMID: 8040032</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; BIOLOGY AND MEDICINE, APPLIED STUDIES ; Deoxyglucose - analogs & derivatives ; Deoxyglucose - pharmacokinetics ; DIAGNOSIS ; Diagnosis, Differential ; Edema - diagnosis ; Edema - etiology ; Ent. Stomatology ; Fluorine radioisotope ; Fluorine Radioisotopes ; Fluorodeoxyglucose F18 ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Laryngeal Neoplasms - diagnostic imaging ; Laryngeal Neoplasms - metabolism ; Laryngeal Neoplasms - radiotherapy ; Laryngectomy ; LARYNX ; Larynx - diagnostic imaging ; Larynx - metabolism ; Larynx - surgery ; local ; Medical sciences ; Necrosis ; Neoplasm recurrence ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - diagnostic imaging ; Neoplasm Recurrence, Local - metabolism ; NEOPLASMS ; Positron emission tomography ; Radiation injuries ; Radiation Injuries - diagnosis ; Radiation Injuries - diagnostic imaging ; Radiation Injuries - metabolism ; Radionuclide investigations ; RADIOTHERAPY ; Radiotherapy - adverse effects ; SIDE EFFECTS ; Tomography, Emission-Computed</subject><ispartof>International Journal of Radiation Oncology, Biology and Physics, 1994-07, Vol.29 (4), p.841-845</ispartof><rights>1994</rights><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-df0091ab01a607d4e4c910d7d9e92ac348c283150b4ca49ba8a74c8e4159553b3</citedby><cites>FETCH-LOGICAL-c442t-df0091ab01a607d4e4c910d7d9e92ac348c283150b4ca49ba8a74c8e4159553b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/0360301694905746$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4159395$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8040032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/86492$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Greven, Kathryn M.</creatorcontrib><creatorcontrib>Williams, Daniel W.</creatorcontrib><creatorcontrib>Keyes, John W.</creatorcontrib><creatorcontrib>McGuirt, W.Fred</creatorcontrib><creatorcontrib>Harkness, Beth A.</creatorcontrib><creatorcontrib>Watson, Nat E.</creatorcontrib><creatorcontrib>Raben, Milton</creatorcontrib><creatorcontrib>Frazier, Lisa C.</creatorcontrib><creatorcontrib>Geisinger, Kim R.</creatorcontrib><creatorcontrib>Cappellari, James O.</creatorcontrib><title>Distinguishing tumor recurrence from irradiation sequelae with positron emission tomography in patients treated for larynx cancer</title><title>International Journal of Radiation Oncology, Biology and Physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose
: Distinguishing persistent or recurrent tumor from postradiation edema, or soft tissue/cartilage necrosis in patients treated for carcinoma of the larynx can be difficult. Because recurrent tumor is often submucosal, multiple deep biopsies may be necessary before a diagnosis can be established. Positron emission tomography with 18F-2fluoro-2deoxyglucose (FDG) was studied for its ability to aid in this problem.
Methods and Materials
: Positron emission tomography (18FDG) scans were performed on 11 patients who were suspected of having persistent or recurrent tumor after radiation treatment for carcinoma of the larynx. Patients underwent thorough history and physical examinations, scans with computerized tomography, and pathologic evaluation when indicated. Standard uptake values were used to quantitate the FDG uptake in the larynx.
Results
: The time between completion of radiation treatment and positron emission tomography examination ranged from 2 to 26 months with a median of 6 months. Ten patients underwent computed tomography (CT) of the larynx, which revealed edema of the larynx (six patients), glottic mass (four patients), and cervical nodes (one patient). Positron emission tomography scans revealed increased FDG uptake in the larynx in five patients and laryngectomy confirmed the presence of carcinoma in these patients. Five patients had positron emission tomography results consistent with normal tissue changes in the larynx, and one patient had increased FDG uptake in neck nodes. This patient underwent laryngectomy, and no cancer was found in the primary site, but nodes were pathologically positive. One patient had slightly elevated FDG uptake and negative biopsy results. The remaining patients have been followed for 11 to 14 months since their positron emission studies and their examinations have remained stable. In patients without tumor, average standard uptake values of the larynx ranged from 2.4 to 4.7, and in patients with tumor, the range was 4.9 to 10.7.
Conclusion
: Positron emission tomography with labeled FDG appears to be useful in distinguishing benign from malignant changes in the larynx after radiation treatment. This noninvasive technique may be preferable to biopsy, which could traumatize radiation-damaged tissues and precipitate necrosis.</description><subject>Biological and medical sciences</subject><subject>BIOLOGY AND MEDICINE, APPLIED STUDIES</subject><subject>Deoxyglucose - analogs & derivatives</subject><subject>Deoxyglucose - pharmacokinetics</subject><subject>DIAGNOSIS</subject><subject>Diagnosis, Differential</subject><subject>Edema - diagnosis</subject><subject>Edema - etiology</subject><subject>Ent. Stomatology</subject><subject>Fluorine radioisotope</subject><subject>Fluorine Radioisotopes</subject><subject>Fluorodeoxyglucose F18</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laryngeal Neoplasms - diagnostic imaging</subject><subject>Laryngeal Neoplasms - metabolism</subject><subject>Laryngeal Neoplasms - radiotherapy</subject><subject>Laryngectomy</subject><subject>LARYNX</subject><subject>Larynx - diagnostic imaging</subject><subject>Larynx - metabolism</subject><subject>Larynx - surgery</subject><subject>local</subject><subject>Medical sciences</subject><subject>Necrosis</subject><subject>Neoplasm recurrence</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - diagnostic imaging</subject><subject>Neoplasm Recurrence, Local - metabolism</subject><subject>NEOPLASMS</subject><subject>Positron emission tomography</subject><subject>Radiation injuries</subject><subject>Radiation Injuries - diagnosis</subject><subject>Radiation Injuries - diagnostic imaging</subject><subject>Radiation Injuries - metabolism</subject><subject>Radionuclide investigations</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy - adverse effects</subject><subject>SIDE EFFECTS</subject><subject>Tomography, Emission-Computed</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0EKkvhH4DkA0JwCNix48QXJFSgIFXiAhI3y3EmXaPEDmOnpUf-OQ672mNPY3m-Gfu9R8hzzt5yxtU7JhSrRDm91vKNZk0rK_WA7HjX6ko0zc-HZHdCHpMnKf1ijHHeyjNy1jHJmKh35O9Hn7IP16tP-1JoXueIFMGtiBAc0BHjTD2iHbzNPgaa4PcKkwV66_OeLjH5jOUaZp_S1s9xjtdol_0d9YEuZQhCTjQj2AwDHcv6yeJd-EOdLQ_gU_JotFOCZ8d6Tn58_vT94kt19e3y68WHq8pJWedqGBnT3PaMW8XaQYJ0mrOhHTTo2johO1d3gjesl85K3dvOttJ1IHmjm0b04pzQw95YBJvkfAa3dzEEcNl0Suq6IK8OyIKxiEzZFFEOpskGiGsyXGmplJAFlAfQYUwJYTQL-rmoMpyZLRyzOW82542W5n84RpWxF8f9az_DcBo6plH6L499m5ydRiwG-XTCNilCNwV7f8Cg2HXjATc1W1iDx03MEP39__gH6ait6w</recordid><startdate>19940701</startdate><enddate>19940701</enddate><creator>Greven, Kathryn M.</creator><creator>Williams, Daniel W.</creator><creator>Keyes, John W.</creator><creator>McGuirt, W.Fred</creator><creator>Harkness, Beth A.</creator><creator>Watson, Nat E.</creator><creator>Raben, Milton</creator><creator>Frazier, Lisa C.</creator><creator>Geisinger, Kim R.</creator><creator>Cappellari, James O.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>OTOTI</scope></search><sort><creationdate>19940701</creationdate><title>Distinguishing tumor recurrence from irradiation sequelae with positron emission tomography in patients treated for larynx cancer</title><author>Greven, Kathryn M. ; Williams, Daniel W. ; Keyes, John W. ; McGuirt, W.Fred ; Harkness, Beth A. ; Watson, Nat E. ; Raben, Milton ; Frazier, Lisa C. ; Geisinger, Kim R. ; Cappellari, James O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-df0091ab01a607d4e4c910d7d9e92ac348c283150b4ca49ba8a74c8e4159553b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Biological and medical sciences</topic><topic>BIOLOGY AND MEDICINE, APPLIED STUDIES</topic><topic>Deoxyglucose - analogs & derivatives</topic><topic>Deoxyglucose - pharmacokinetics</topic><topic>DIAGNOSIS</topic><topic>Diagnosis, Differential</topic><topic>Edema - diagnosis</topic><topic>Edema - etiology</topic><topic>Ent. Stomatology</topic><topic>Fluorine radioisotope</topic><topic>Fluorine Radioisotopes</topic><topic>Fluorodeoxyglucose F18</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laryngeal Neoplasms - diagnostic imaging</topic><topic>Laryngeal Neoplasms - metabolism</topic><topic>Laryngeal Neoplasms - radiotherapy</topic><topic>Laryngectomy</topic><topic>LARYNX</topic><topic>Larynx - diagnostic imaging</topic><topic>Larynx - metabolism</topic><topic>Larynx - surgery</topic><topic>local</topic><topic>Medical sciences</topic><topic>Necrosis</topic><topic>Neoplasm recurrence</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - diagnostic imaging</topic><topic>Neoplasm Recurrence, Local - metabolism</topic><topic>NEOPLASMS</topic><topic>Positron emission tomography</topic><topic>Radiation injuries</topic><topic>Radiation Injuries - diagnosis</topic><topic>Radiation Injuries - diagnostic imaging</topic><topic>Radiation Injuries - metabolism</topic><topic>Radionuclide investigations</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy - adverse effects</topic><topic>SIDE EFFECTS</topic><topic>Tomography, Emission-Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Greven, Kathryn M.</creatorcontrib><creatorcontrib>Williams, Daniel W.</creatorcontrib><creatorcontrib>Keyes, John W.</creatorcontrib><creatorcontrib>McGuirt, W.Fred</creatorcontrib><creatorcontrib>Harkness, Beth A.</creatorcontrib><creatorcontrib>Watson, Nat E.</creatorcontrib><creatorcontrib>Raben, Milton</creatorcontrib><creatorcontrib>Frazier, Lisa C.</creatorcontrib><creatorcontrib>Geisinger, Kim R.</creatorcontrib><creatorcontrib>Cappellari, James O.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>OSTI.GOV</collection><jtitle>International Journal of Radiation Oncology, Biology and Physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Greven, Kathryn M.</au><au>Williams, Daniel W.</au><au>Keyes, John W.</au><au>McGuirt, W.Fred</au><au>Harkness, Beth A.</au><au>Watson, Nat E.</au><au>Raben, Milton</au><au>Frazier, Lisa C.</au><au>Geisinger, Kim R.</au><au>Cappellari, James O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distinguishing tumor recurrence from irradiation sequelae with positron emission tomography in patients treated for larynx cancer</atitle><jtitle>International Journal of Radiation Oncology, Biology and Physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>1994-07-01</date><risdate>1994</risdate><volume>29</volume><issue>4</issue><spage>841</spage><epage>845</epage><pages>841-845</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose
: Distinguishing persistent or recurrent tumor from postradiation edema, or soft tissue/cartilage necrosis in patients treated for carcinoma of the larynx can be difficult. Because recurrent tumor is often submucosal, multiple deep biopsies may be necessary before a diagnosis can be established. Positron emission tomography with 18F-2fluoro-2deoxyglucose (FDG) was studied for its ability to aid in this problem.
Methods and Materials
: Positron emission tomography (18FDG) scans were performed on 11 patients who were suspected of having persistent or recurrent tumor after radiation treatment for carcinoma of the larynx. Patients underwent thorough history and physical examinations, scans with computerized tomography, and pathologic evaluation when indicated. Standard uptake values were used to quantitate the FDG uptake in the larynx.
Results
: The time between completion of radiation treatment and positron emission tomography examination ranged from 2 to 26 months with a median of 6 months. Ten patients underwent computed tomography (CT) of the larynx, which revealed edema of the larynx (six patients), glottic mass (four patients), and cervical nodes (one patient). Positron emission tomography scans revealed increased FDG uptake in the larynx in five patients and laryngectomy confirmed the presence of carcinoma in these patients. Five patients had positron emission tomography results consistent with normal tissue changes in the larynx, and one patient had increased FDG uptake in neck nodes. This patient underwent laryngectomy, and no cancer was found in the primary site, but nodes were pathologically positive. One patient had slightly elevated FDG uptake and negative biopsy results. The remaining patients have been followed for 11 to 14 months since their positron emission studies and their examinations have remained stable. In patients without tumor, average standard uptake values of the larynx ranged from 2.4 to 4.7, and in patients with tumor, the range was 4.9 to 10.7.
Conclusion
: Positron emission tomography with labeled FDG appears to be useful in distinguishing benign from malignant changes in the larynx after radiation treatment. This noninvasive technique may be preferable to biopsy, which could traumatize radiation-damaged tissues and precipitate necrosis.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8040032</pmid><doi>10.1016/0360-3016(94)90574-6</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0360-3016 |
| ispartof | International Journal of Radiation Oncology, Biology and Physics, 1994-07, Vol.29 (4), p.841-845 |
| issn | 0360-3016 1879-355X |
| language | eng |
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| subjects | Biological and medical sciences BIOLOGY AND MEDICINE, APPLIED STUDIES Deoxyglucose - analogs & derivatives Deoxyglucose - pharmacokinetics DIAGNOSIS Diagnosis, Differential Edema - diagnosis Edema - etiology Ent. Stomatology Fluorine radioisotope Fluorine Radioisotopes Fluorodeoxyglucose F18 Humans Investigative techniques, diagnostic techniques (general aspects) Laryngeal Neoplasms - diagnostic imaging Laryngeal Neoplasms - metabolism Laryngeal Neoplasms - radiotherapy Laryngectomy LARYNX Larynx - diagnostic imaging Larynx - metabolism Larynx - surgery local Medical sciences Necrosis Neoplasm recurrence Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - diagnostic imaging Neoplasm Recurrence, Local - metabolism NEOPLASMS Positron emission tomography Radiation injuries Radiation Injuries - diagnosis Radiation Injuries - diagnostic imaging Radiation Injuries - metabolism Radionuclide investigations RADIOTHERAPY Radiotherapy - adverse effects SIDE EFFECTS Tomography, Emission-Computed |
| title | Distinguishing tumor recurrence from irradiation sequelae with positron emission tomography in patients treated for larynx cancer |
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