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Wockner RS, Seethala RR, Emeto TI, McCaul JA, Subramaniam SS. Epithelial-myoepithelial carcinoma of the maxillofacial and sinonasal region: a systematic review of presenting characteristics, treatment modalities, and associated outcomes. Int J Oral Maxillofac Surg 2023; 52:1-12. [PMID: 35667947 PMCID: PMC11227655 DOI: 10.1016/j.ijom.2022.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland malignancy. Controversy exists in the literature regarding the effectiveness of treatment modalities employed in the management of EMC. This systematic review was undertaken to understand the presenting characteristics of EMC and identify the most common treatment modalities and their associated outcomes, in order to help guide an evidenced-based approach to the algorithm of care. The MEDLINE (PubMed) and Embase databases were searched (up to February 23, 2022), and the review was performed in accordance with the PRISMA statement. Fifty-seven studies (51 case reports and six case series) describing 91 cases of EMC were included in this review. In the included studies, a slow-growing painless mass was the most common presenting clinical feature. EMC was most frequently treated with surgery alone (65%). Local disease recurrence occurred in 24% of the cases and metastatic disease in 11%. A positive surgical margin was found to be associated with a higher risk of recurrence (P < 0.001), while adjuvant radiotherapy was associated with a decreased risk of local disease recurrence (P = 0.034). Metastatic disease and multimodal therapy were found to be associated with decreased disease-free and overall survival (all P < 0.05). The current literature supports surgery with clear margins as the mainstay of treatment for EMC of the salivary and seromucous glands of the head and neck. In certain situations, radiotherapy may improve disease-free survival.
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Affiliation(s)
- R S Wockner
- University of Otago, School of Medicine, Wellington, New Zealand.
| | - R R Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - T I Emeto
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; World Health Organization Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | - J A McCaul
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - S S Subramaniam
- Department of Oral and Maxillofacial Surgery, Royal Melbourne Hospital, Victoria, Australia; Department of Oral and Maxillofacial Surgery, Townsville University Hospital, Queensland, Australia
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Kim ES, Yoon DY, Moon JY, Baek S, Han YM, Seo YL, Yun EJ. Detection of loco-regional recurrence in malignant head and neck tumors: a comparison of CT, MRI, and FDG PET-CT. Acta Radiol 2019; 60:186-195. [PMID: 29754496 DOI: 10.1177/0284185118776504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The early and accurate detection of local or regional recurrence of head and neck tumor is critically important. PURPOSE To compare the diagnostic accuracy of contrast-enhanced computed tomography (CT), contrast-enhanced magnetic resonance imaging (MRI), and fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT, alone and in combination, in detecting the locoregional recurrence of malignant head and neck tumor. MATERIAL AND METHODS A total of 93 patients with loco-regional recurrence of malignant head and neck tumors underwent CT, MRI, and PET-CT within 30 days before surgery. CT, MRI, and PET-CT for each patient were retrospectively reviewed to determine the presence of recurrent tumors in the primary site on a patient-by-patient basis and that of regional lymph nodes on a level-by-level basis. The diagnostic accuracy of CT, MRI, and PET-CT, alone and combined, were accessed with the postoperative histopathological findings or with 12-month follow-up results as the standard of reference. RESULTS The sensitivity/specificity/and accuracy of CT, MRI, and PET-CT for the detection of primary site recurrence was 89.9/85.7/89.3%, 94.9/85.7/93.6%, and 97.5/92.9/96.8%, respectively. The sensitivity/specificity/accuracy of CT, MRI, and PET-CT for the detection of nodal recurrence was 66.3/99.4/92.4%, 74.7/99.4/94.2%, and 85.5/94.9/93.0%, respectively. MRI + PET-CT achieved the best performance in the receiver operating characteristics curve analysis (Az value = 0.958 for primary site recurrence and 0.929 for nodal recurrence). CONCLUSION MRI + PET-CT offered the highest diagnostic performance in the detection of loco-regional recurrence of malignant head and neck tumor, compared with CT, MRI, PET-CT, and other combinations including CT.
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Affiliation(s)
- Eun Soo Kim
- Department of Radiology Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do, Republic of Korea
| | - Dae Young Yoon
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Ji Yoon Moon
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Sora Baek
- Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - You Mie Han
- Department of Nuclear Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Gyeonggi-do, Republic of Korea
| | - Young Lan Seo
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Eun Joo Yun
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
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Seeburg DP, Baer AH, Aygun N. Imaging of Patients with Head and Neck Cancer. Oral Maxillofac Surg Clin North Am 2018; 30:421-433. [DOI: 10.1016/j.coms.2018.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
Imaging plays a multifaceted role in the diagnosis and characterization of head and neck oncological patients and is integral to their care. Given the complexity of treatment, a multimodality approach is often necessary. With the advent of new technologies, imaging can also be used to predict tumor behavior and treatment response. In this chapter, with selected case examples, we describe the various imaging modalities available and offer suggestions on their utilization.
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Affiliation(s)
- Ravi Prasad
- Cedars-Sinai Medical Center, Los Angeles, USA.
| | - Beth Chen
- City of Hope National Medical Center, Duarte, USA
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Staging and follow-up of high-grade malignant salivary gland tumours: The role of traditional versus functional imaging approaches – A review. Oral Oncol 2016; 60:157-66. [DOI: 10.1016/j.oraloncology.2016.04.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 04/19/2016] [Accepted: 04/28/2016] [Indexed: 02/08/2023]
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Klingenstein A, Mueller-Lisse GU, Haug AR, Garip-Kuebler A, Miller CV, Hintschich CR. Combined positron emission tomography/computed tomography (PET/CT) for imaging of orbital tumours and tumours extending into the orbit. Br J Ophthalmol 2016; 100:1403-8. [PMID: 26769673 DOI: 10.1136/bjophthalmol-2015-307988] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 12/13/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess clinical and radiological performance of combined positron emission tomography/computed tomography (PET/CT) in patients with secondary and primary intraorbital tumours. METHODS 14 adults with secondary and 1 child with primary orbital masses underwent combined whole-body PET/CT. Radiopharmaceutical tracers applied were (18F)-fluorodeoxyglucose, (18F)-fluoroethylcholine (FEC) and (68Ga)-DOTATATE. Histopathology and/or all conventional radiographic work-up and clinical course served as standard of reference. Descriptive statistics and Fisher's exact test were used for analysis. RESULTS PET/CT detected all orbital masses. All 15 patients had malignant disease. Local osseous infiltration was correctly identified in 11 patients. Lymph node metastases were present in two of eight patients (25%) with haematogenous orbital metastases and in five of six patients (83%) with infiltrative carcinoma (p=0.05). Further distant metastases were present in all eight patients suffering from orbital metastases, but only one patient with infiltrative carcinoma (17%) presented with disseminated disease (p=0.003). In one metastasis, PET/CT excluded vital orbital tumour tissue after radiation therapy. Local recurrence was detected in another patient suffering from prostate cancer. CONCLUSION PET/CT is a sensitive tool for the detection and localisation of orbital masses, enabling assessment of both morphology and cell metabolism. Detailed imaging of the head and neck region with a small field-of-view should be performed when suspecting lymphatic metastases. As metastatic disease to the orbit is associated with advanced disease, focus should be laid on whole-body imaging for staging of these patients. Different radiopharmaceutical tracers can be applied to distinguish the origin of orbital metastases.
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Affiliation(s)
| | | | - Alexander R Haug
- Department of Nuclear Medicine, Ludwig-Maximilians-University, Munich, Germany Division of Nuclear Medicine, Medical University Vienna, Vienna, Austria
| | | | - Christina V Miller
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
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Nivison-Smith L, O'Brien BJ, Truong M, Guo CX, Kalloniatis M, Acosta ML. Vinpocetine modulates metabolic activity and function during retinal ischemia. Am J Physiol Cell Physiol 2015; 308:C737-49. [PMID: 25696811 DOI: 10.1152/ajpcell.00291.2014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 02/17/2015] [Indexed: 12/18/2022]
Abstract
Vinpocetine protects against a range of degenerative conditions and insults of the central nervous system via multiple modes of action. Little is known, however, of its effects on metabolism. This may be highly relevant, as vinpocetine is highly protective against ischemia, a process that inhibits normal metabolic function. This study uses the ischemic retina as a model to characterize vinpocetine's effects on metabolism. Vinpocetine reduced the metabolic demand of the retina following ex vivo hypoxia and ischemia to normal levels based on lactate dehydrogenase activity. Vinpocetine delivered similar effects in an in vivo model of retinal ischemia-reperfusion, possibly through increasing glucose availability. Vinpocetine's effects on glucose also appeared to improve glutamate homeostasis in ischemic Müller cells. Other actions of vinpocetine following ischemia-reperfusion, such as reduced cell death and improved retinal function, were possibly a combination of the drug's actions on metabolism and other retinal pathways. Vinpocetine's metabolic effects appeared independent of its other known actions in ischemia, as it recovered retinal function in a separate metabolic model where the glutamate-to-glutamine metabolic pathway was inhibited in Müller cells. The results of this study indicate that vinpocetine mediates ischemic damage partly through altered metabolism and has potential beneficial effects as a treatment for ischemia of neuronal tissues.
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Affiliation(s)
- Lisa Nivison-Smith
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Brendan J O'Brien
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Mai Truong
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Cindy X Guo
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Michael Kalloniatis
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand; Centre for Eye Health, University of New South Wales, Sydney, Australia; and
| | - Monica L Acosta
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
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Vander Poorten V, Bradley PJ, Takes RP, Rinaldo A, Woolgar JA, Ferlito A. Diagnosis and management of parotid carcinoma with a special focus on recent advances in molecular biology. Head Neck 2011; 34:429-40. [DOI: 10.1002/hed.21706] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 10/19/2010] [Accepted: 10/26/2010] [Indexed: 11/05/2022] Open
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King KG, Kositwattanarerk A, Genden E, Kao J, Som PM, Kostakoglu L. Cancers of the Oral Cavity and Oropharynx: FDG PET with Contrast-enhanced CT in the Posttreatment Setting. Radiographics 2011; 31:355-73. [DOI: 10.1148/rg.312095765] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Comparison of 18F-FDG and 11C-choline PET/CT for detecting recurrences in patients with nonsquamous cell head and neck malignancies. Nucl Med Commun 2010; 31:931-7. [DOI: 10.1097/mnm.0b013e32833f3921] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vander Poorten VLM, Marchal F, Nuyts S, Clement PMJ. Parotid carcinoma: Current diagnostic workup and treatment. Indian J Surg Oncol 2010; 1:96-111. [PMID: 22930624 PMCID: PMC3421013 DOI: 10.1007/s13193-010-0022-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 04/30/2010] [Indexed: 01/04/2023] Open
Abstract
In this review we present recent progress in diagnostic workup, prognostic evaluation, treatment options and resulting outcomes. Whenever possible, complete resection remains the mainstay of treatment. Sacrifice of facial nerve branches is reserved for the clinically or electromyographically dysfunctioning facial nerve. Clinical or radiological neck disease demands combined surgery and radiotherapy. Treatment of the N0 neck is indicated for advanced stage-high grade tumors but the question remains unanswered whether this should be surgical or radiotherapeutic elective treatment. Surgery alone will cure low stage, low grade tumors, that show no additional negative prognostic factors following adequate resection. In all other tumors postoperative radiotherapy will improve locoregional control. This approach results in good locoregional control, in a way that distant metastasis remains the typical presentation of treatment failure. In this setting, the results of systemic treatment today remain limited, but a huge effort in the molecular biology field has been done to introduce targeted therapy into this domain of head and neck cancer. Disease control remains variable within the patient population. This variation can increasingly be predicted by systems that incorporate the combined information of multivariately identified and quantified prognostic factors into an individualized prognosis for the parotid carcinoma patient.
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Affiliation(s)
- Vincent L. M. Vander Poorten
- Department of Otorhinolaryngology, Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
- European Salivary Gland Society, Geneva, Switzerland
| | - Francis Marchal
- Department of Otorhinolaryngology, Head and Neck Surgery, CHU Geneve and Hôpital Général Beaulieu, European Salivary Gland Society, Geneva, Switzerland
| | - Sandra Nuyts
- Department of Radiotherapy-Oncology and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
| | - Paul M. J. Clement
- Department of Medical Oncology and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
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12
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Detection of Metastatic Cervical Lymph Nodes in Recurrent Papillary Thyroid Carcinoma. J Comput Assist Tomogr 2009; 33:805-10. [DOI: 10.1097/rct.0b013e31818fb3f1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Use of 18F-fluorodeoxyglucose positron emission tomography in patients with rare head and neck cancers. Clin Exp Otorhinolaryngol 2008; 1:103-9. [PMID: 19434281 PMCID: PMC2671791 DOI: 10.3342/ceo.2008.1.2.103] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 06/08/2008] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES The clinical utility of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been demonstrated in major head and neck cancers (HNCs) but is unclear in rare HNCs. We therefore evaluated FDG PET in the management of patients with rare HNCs. METHODS FDG PET and CT/MRI scanning were performed at the initial staging and/or the follow-up in 24 patients with rare HNCs, 10 with melanoma, 9 with sarcoma, 3 with olfactory neuroblastomas, and 2 with basal cell carcinoma. The diagnostic accuracy of CT and FDG PET for detecting primary tumors and metastases were compared with a histopathologic reference. The association between the PET results and the clinicopathologic parameters predicting tumor invasion, histologic grade and disease-free survival (DFS), was assessed. RESULTS The overall accuracies of FDG PET and CT/MRI were 92% and 79%, respectively, for detecting primary tumors and 91% and 74%, respectively, for nodal metastases, but the differences were not significant due to the small number of patients. The sensitivity and specificity of FDG PET for detecting distant metastases and second primary tumors were 100% and 87%, respectively. Follow-up FDG PET correctly diagnosed locoregional recurrence in all 12 patients, as shown by biopsy, and distant metastases in 6 patients. However, thickness of melanoma, histologic grade of sarcoma, and DFS were not associated with tumor FDG uptake. CONCLUSION FDG PET may be useful for staging, posttreatment monitoring, and detection of distant metastases and second primary tumors in patients with rare HNCs.
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Shah VN, Branstetter BF. Oncocytoma of the parotid gland: a potential false-positive finding on 18F-FDG PET. AJR Am J Roentgenol 2007; 189:W212-4. [PMID: 17885033 DOI: 10.2214/ajr.05.1213] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Vinil N Shah
- Department of Radiology, University of Pittsburgh School of Medicine, 200 Lothrop St., PUH Room D-132, Pittsburgh, PA 15213, USA
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Bhagat N, Zuckier LS, Hameed M, Cathcart C, Baredes S, Ghesani NV. Detection of recurrent adenoid cystic carcinoma with PET-CT. Clin Nucl Med 2007; 32:574-7. [PMID: 17581353 DOI: 10.1097/rlu.0b013e3180646b0f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Nikhil Bhagat
- Departments of Radiology, New Jersey Medical School, Newark, NJ, USA
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Kuba VM, Caetano R, Coeli CM, Vaisman M. Utilidade da tomografia de emissão de pósitrons com fluoro-deoxiglicose (FDG-PET) na avaliação do câncer de tireóide: uma revisão sistemática. ACTA ACUST UNITED AC 2007; 51:961-71. [DOI: 10.1590/s0004-27302007000600011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Accepted: 01/23/2007] [Indexed: 11/22/2022]
Abstract
Após o tratamento inicial do câncer tireoidiano, a detecção de prováveis recorrências e/ou metástases se faz através da dosagem de marcadores séricos e estudos de imagem. Essas técnicas podem ser negativas apesar de evidências bioquímicas de doença metastática. A tomografia de emissão de pósitrons com fluorodeoxiglicose (FDG-PET) tem sido proposta como um teste acurado para detectá-la. O objetivo deste estudo é apresentar uma síntese das evidências obtidas através de revisão sistemática sobre a acurácia do FDG-PET na localização de metástases de câncer tireoidiano previamente tratado, nos quais as modalidades convencionais falharam na sua detecção. Foi realizada uma pesquisa bibliográfica no MEDLINE de todos os trabalhos relativos a FDG-PET e carcinoma tireoidiano diferenciado, indexados até setembro de 2005. Foram obtidas 216 citações e 17 trabalhos foram incluídos, 71% publicados a partir de 2000. A sensibilidade da FDG-PET foi elevada, com apenas um trabalho apresentando sensibilidade inferior a 75%. A especificidade, examinada em 12 estudos, foi menor que 75% em 3 estudos. Em 41% dos trabalhos existia pelo menos um teste comparativo com o FDG-PET. Os resultados apontam o FDG-PET como um teste diagnóstico útil para a detecção e localização de metástases do câncer tireoidiano, com implicações diretas no tratamento dos pacientes.
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Chen AM, Garcia J, Lee NY, Bucci MK, Eisele DW. Patterns of nodal relapse after surgery and postoperative radiation therapy for carcinomas of the major and minor salivary glands: What is the role of elective neck irradiation? Int J Radiat Oncol Biol Phys 2007; 67:988-94. [PMID: 17234357 DOI: 10.1016/j.ijrobp.2006.10.044] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2006] [Revised: 10/27/2006] [Accepted: 10/29/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the incidence of nodal relapses from carcinomas of the salivary glands among patients with clinically negative necks in an attempt to determine the potential utility of elective neck irradiation (ENI). METHODS AND MATERIALS Between 1960 and 2004, 251 patients with clinically N0 carcinomas of the salivary glands were treated with surgery and postoperative radiation therapy. None of the patients had undergone previous neck dissection. Histology was: adenoid cystic (84 patients), mucoepidermoid (60 patients), adenocarcinoma (58 patients), acinic cell (21 patients), undifferentiated (11 patients), carcinoma ex pleomorphic adenoma (7 patients), squamous cell (7 patients), and salivary duct carcinoma (3 patients); 131 patients (52%) had ENI. Median follow-up was 62 months (range, 3-267 months). RESULTS The 5- and 10-year actuarial estimates of nodal relapse were 11% and 13%, respectively. The 10-year actuarial rates of nodal failure were 7%, 5%, 12%, and 16%, for patients with T1, T2, T3, and T4 disease, respectively (p = 0.11). The use of ENI reduced the 10-year nodal failure rate from 26% to 0% (p = 0.0001). The highest crude rates of nodal relapse among those treated without ENI were found in patients with squamous cell carcinoma (67%), undifferentiated carcinoma (50%), adenocarcinoma (34%), and mucoepidermoid carcinoma (29%). There were no nodal failures observed among patients with adenoid cystic or acinic cell histology. CONCLUSION ENI effectively prevents nodal relapses and should be used for select patients at high risk for regional failure.
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Affiliation(s)
- Allen M Chen
- Department of Radiation Oncology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA, USA.
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Ekberg T, Sörensen J, Engström M, Blomquist E, Sundin A, Anniko M. Clinical impact of positron emission tomography (PET) with (18F)fluorodeoxyglucose (FDG) in head and neck tumours. Acta Otolaryngol 2007; 127:186-93. [PMID: 17364351 DOI: 10.1080/00016480600801407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
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 (18F)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.
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Affiliation(s)
- Tomas Ekberg
- Department of Otorhinolaryngology and Head & Neck Surgery, University Hospital (Akademiska Sjukhuset), Uppsala, Sweden.
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Wild D, Eyrich GK, Ciernik IF, Stoeckli SJ, Schuknecht B, Goerres GW. In-line (18)F-fluorodeoxyglucose positron emission tomography with computed tomography (PET/CT) in patients with carcinoma of the sinus/nasal area and orbit. J Craniomaxillofac Surg 2005; 34:9-16. [PMID: 16343913 DOI: 10.1016/j.jcms.2005.08.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2004] [Accepted: 08/30/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) are the standard imaging techniques to evaluate patients with carcinoma in the sinus/nasal area and orbit. The use of positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) in such patients is as yet less well established. PURPOSE The aim of this study was to assess the clinical impact of PET co-registered with CT (PET/CT). PATIENTS Evaluation of 21 consecutive patients. METHODS A retrospective analysis of the whole body PET/CT studies was done. Images were assessed visually without knowing the results of the other imaging technique. Histology and clinical follow-up served to verify lesions. The clinical impact on therapy was assessed together with the physician in charge. RESULTS All patients underwent PET/CT and CT or MRI for staging (n=9 scans) and restaging (n=17 scans) without treatment between the examinations. PET/CT changed the treatment protocol in 2 patients at staging and in 7 at re-staging. Distant metastases were found in 5 and a secondary tumour in 1 patient. CONCLUSIONS Whole body PET/CT adds clinically important information to CT or MRI, thus, influencing treatment.
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Affiliation(s)
- Damian Wild
- Division of Nuclear Medicine, Institute of Diagnostic Radiology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
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Mackie GC, Yarram SG. Pleomorphic adenoma simulating metastatic squamous cell carcinoma on f-18 fluorodeoxyglucose positron emission tomography. Clin Nucl Med 2004; 29:743-4. [PMID: 15483498 DOI: 10.1097/00003072-200411000-00022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gavin C Mackie
- Department of Radiology, Division of Nuclear Medicine, University of Michigan Health System, Ann Arbor, Michigan 48107-0028, USA.
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