PET/CT versus PET/MRT bei Kopf-Hals-Tumoren

Die Einführung der integrierten Positronen-Emissions-Tomografie/Magnetresonanztomografie (PET/MRT) bietet in der Bildgebung von Kopf-/Hals-Tumoren neue Möglichkeiten der funktionellen Weichteildarstellung. Insbesondere in der Bildgebung von Plattenepithelkarzinomen des Kopf-/Hals-Bereichs bietet die PET/MRT deutliche Vorteile in der Primär- und Rezidivdiagnostik. Daher soll im Rahmen dieser Übersichtsarbeit der aktuelle Forschungsstand dargestellt werden und das zukünftige Potenzial dieser Modalität aufgezeigt werden.

Publication History

Article published online:
31 May 2021

• Literatur

• 1 Robert-Koch-Institut. Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. Krebs in Deutschland für 2013/2014. 2017 11. Ausgabe.
• 2 Haughey BH, Hinni ML, Salassa JR. et al. Transoral laser microsurgery as primary treatment for advanced-stage oropharyngeal cancer: A united states multicenter study. Head & Neck 2011; 33: 1683-1694
• 3 Grant DG, Hinni ML, Salassa JR. et al. Oropharyngeal Cancer: A Case for Single Modality Treatment With Transoral Laser Microsurgery. Arch Otolaryngol Head Neck Surg 2009; 135: 1225-1230
• 4 Genden EM, Desai S, Sung CK. Transoral robotic surgery for the management of head and neck cancer: A preliminary experience. Head & Neck 2009; 31: 283-289
• 5 Hurtuk A, Marcinow A, Agrawal A. et al. Outcomes of transoral robotic surgery: a preliminary clinical experience. Otolaryngol Head Neck Surg 2011; 145: 248-253
• 6 Schwartz LH, Ozsahin M, Zhang GN. et al. Synchronous and metachronous head and neck carcinomas. Cancer 1994; 74: 1933-1938
• 7 Massa ST, Osazuwa-Peters N, Christopher KM. et al. Competing causes of death in the head and neck cancer population. Oral Oncol 2017; 65: 8-15
• 8 Wang X, Mauer EA, Christos P. et al. First Clinical Report on Comparative Treatment and Survival Outcomes in Second Cancers after Primary Head and Neck Cancer: A Population-Based Study. Cureus 2017; 9: e1284
• 9 Liu SA, Wong YK, Lin JC. et al. Impact of recurrence interval on survival of oral cavity squamous cell carcinoma patients after local relapse. Otolaryngol Head Neck Surg 2007; 136: 112-118
• 10 Mücke T, Wagenpfeil S, Kesting MR. et al. Recurrence interval affects survival after local relapse of oral cancer. Oral Oncology 2009; 45: 687-691
• 11 Ogden GR. Second malignant tumours in head and neck cancer. BMJ 1991; 302: 193-194
• 12 Schwartz DL, Barker J, Chansky K. et al. Postradiotherapy surveillance practice for head and neck squamous cell carcinoma—too much for too little?. Head Neck 2003; 25: 990-999
• 13 Rogers SN, Brown JS, Woolgar JA. et al. Survival following primary surgery for oral cancer. Oral Oncology 2009; 45: 201-211
• 14 Rivelli V, Luebbers HT, Weber FE. et al. Screening recurrence and lymph node metastases in head and neck cancer: the role of computer tomography in follow-up. Head Neck Oncol 2011; 3: 18
• 15 Farsi NJ, Rousseau MC, Schlecht N. et al. Aetiological Heterogeneity of Head and Neck Squamous Cell Carcinomas: The Role of Human Papillomavirus Infections, Smoking, and Alcohol. Carcinogenesis 2017; 38: 1188-1195
• 16 Grégoire V, Lefebvre JL, Licitra L. et al. Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21: v184-v186
• 17 Wolff KD, Follmann M, Nast A. The Diagnosis and Treatment of Oral Cavity Cancer. Dtsch Arztebl Int 2012; 109: 829-835
• 18 Stuck BA, Rothmeier N, Mattheis S. et al. Aktueller Stand Salvage-chirurgischer Therapiekonzepte bei Rezidivtumoren des Larynx und Pharynx. Laryngo-Rhino-Otol 2016; 95: 313-319
• 19 Hussain T, Kanaan O, Höing B. et al. Die Rolle der elektiven Neck dissection bei Salvage Laryngektomie – eine retrospektive Analyse. Laryngo-Rhino-Otol 2018; 97: 694-701
• 20 Loeffelbein DJ, Eiber M, Mayr P. et al. Loco-regional recurrence after surgical treatment of oral squamous cell carcinoma: Proposals for follow-up imaging based on literature, national guidelines and institutional experience. Journal of Cranio-Maxillofacial Surgery 2015; 43: 1546-1552
• 21 Leslie A, Fyfe E, Guest P. et al. Staging of Squamous Cell Carcinoma of the Oral Cavity and Oropharynx: A Comparison of Mri and Ct in T- and N-staging. Journal of Computer Assisted Tomography 1999; 23: 43-49
• 22 Howaldt HP, Vorast H, Blecher JC. et al. Ergebnisse aus dem DÖSAKTumorregister. Mund Kiefer GesichtsChir 2000; 4: S216-S225
• 23 McLeod NMH, Jess A, Anand R. et al. Role of chest CT in staging of oropharyngeal cancer: A systematic review. Head & Neck 2009; 31: 548-555
• 24 Colevas AD, Yom SS, Pfister DG. et al. NCCN Guidelines Insights: Head and Neck Cancers, Version 1. 2018. J Natl Compr Canc Netw 2018; 16: 479-490
• 25 Brouwer J, de Bree R, Hoekstra OS. et al. Screening for distant metastases in patients with head and neck cancer: what is the current clinical practice?. Clinical Otolaryngology 2005; 30: 438-443
• 26 Laubenbacher C, Saumweber D, Wagner-Manslau C. et al. Comparison of Fluorine-18-Fluorodeoxyglucose PET, MRI and Endoscopy for Staging Head and Neck Squamous-Cell Carcinomas. J Nucl Med 1995; 36: 1747-1757
• 27 Roh JL, Yeo NK, Kim JS. et al. Utility of 2-[18F] fluoro-2-deoxy-d-glucose positron emission tomography and positron emission tomography/computed tomography imaging in the preoperative staging of head and neck squamous cell carcinoma. Oral Oncology 2007; 43: 887-893
• 28 Dixon PR, Au M, Hosni A. et al. Impact of p16 expression, nodal status, and smoking on oncologic outcomes of patients with head and neck unknown primary squamous cell carcinoma. Head & Neck 2016; 38: 1347-1353
• 29 Haerle SK, Schmid DT, Ahmad N. et al. The value of 18F-FDG PET/CT for the detection of distant metastases in high-risk patients with head and neck squamous cell carcinoma. Oral Oncology 2011; 47: 653-659
• 30 Xu GZ, Guan DJ, He ZY. 18FDG-PET/CT for detecting distant metastases and second primary cancers in patients with head and neck cancer. A meta-analysis. Oral Oncology 2011; 47: 560-565
• 31 Rohde M, Nielsen AL, Johansen J. et al. Head-to-Head Comparison of Chest X-Ray/Head and Neck MRI, Chest CT/Head and Neck MRI, and 18F-FDG PET/CT for Detection of Distant Metastases and Synchronous Cancer in Oral, Pharyngeal, and Laryngeal Cancer. J Nucl Med 2017; 58: 1919-1924
• 32 Cacicedo J, Fernandez I, Del Hoyo O. et al. Should PET/CT be implemented in the routine imaging work-up of locally advanced head and neck squamous cell carcinoma? A prospective analysis. Eur J Nucl Med Mol Imaging 2015; 42: 1378-1389
• 33 Kanda T, Kitajima K, Suenaga Y. et al. Value of retrospective image fusion of 18F-FDG PET and MRI for preoperative staging of head and neck cancer: Comparison with PET/CT and contrast-enhanced neck MRI. European Journal of Radiology 2013; 82: 2005-2010
• 34 Schaarschmidt BM, Heusch P, Buchbender C. et al. Locoregional tumour evaluation of squamous cell carcinoma in the head and neck area: a comparison between MRI, PET/CT and integrated PET/MRI. Eur J Nucl Med Mol Imaging 2016; 43: 92-102
• 35 Sekine T, de Galiza Barbosa F, Kuhn FP. et al. PET+MR versus PET/CT in the initial staging of head and neck cancer, using a trimodality PET/CT +MR system. Clinical Imaging 2017; 42: 232-239
• 36 Sekine T, de Barbosa FG, Delso G. et al. Local resectability assessment of head and neck cancer: Positron emission tomography/MRI versus positron emission tomography/CT. Head & Neck 2017; 39: 1550-1558
• 37 Curtin HD, Ishwaran H, Mancuso AA. et al. Comparison of CT and MR imaging in staging of neck metastases. Radiology 1998; 207: 123-130
• 38 Wax MK, Myers LL, Gona JM. et al. The Role of Positron Emission Tomography in the Evaluation of the N-Positive Neck. Otolaryngol Head Neck Surg 2003; 129: 163-167
• 39 Rodrigues RS, Bozza FA, Christian PE. et al. Comparison of Whole-Body PET/CT, Dedicated High-Resolution Head and Neck PET/CT, and Contrast-Enhanced CT in Preoperative Staging of Clinically M0 Squamous Cell Carcinoma of the Head and Neck. J Nucl Med 2009; 50: 1205-1213
• 40 Assar OS, Fischbein NJ, Caputo GR. et al. Metastatic head and neck cancer: role and usefulness of FDG PET in locating occult primary tumors. Radiology 1999; 210: 177-181
• 41 Abgral R, Querellou S, Potard G. et al. Does 18F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?. J Nucl Med 2009; 50: 24-29
• 42 Lonneux M, Lawson G, Ide C. et al. Positron Emission Tomography With Fluorodeoxyglucose for Suspected Head and Neck Tumor Recurrence in the Symptomatic Patient. The Laryngoscope 2000; 110: 1493-1497
• 43 Kim JW, Roh JL, Kim JS. et al. 18F-FDG PET/CT surveillance at 3–6 and 12 months for detection of recurrence and second primary cancer in patients with head and neck squamous cell carcinoma. Br J Cancer 2013; 109: 2973-2979
• 44 Kikuchi M, Shinohara S, Hino M. et al. Detection of subclinical recurrence or second primary cancer using 18F-FDG PET/CT in patients treated curatively for head and neck squamous cell carcinoma. Head Neck 2016; 38: E511-E518
• 45 Kim SA, Roh JL, Kim JS. et al. 18F-FDG PET/CT surveillance for the detection of recurrence in patients with head and neck cancer. European Journal of Cancer 2017; 72: 62-70
• 46 Hartung-Knemeyer V, Beiderwellen KJ, Buchbender C. et al. Optimizing Positron Emission Tomography Image Acquisition Protocols in Integrated Positron Emission Tomography/magnetic Resonance Imaging. Investigative Radiology 2013; 48: 290-294
• 47 Heusch P, Nensa F, Schaarschmidt B. et al. Diagnostic accuracy of whole-body PET/MRI and whole-body PET/CT for TNM staging in oncology. Eur J Nucl Med Mol Imaging 2015; 42: 42-48
• 48 Antoch G, Bockisch A. Combined PET/MRI: a new dimension in wholebody oncology imaging?. Eur J Nucl Med Mol Imaging 2009; 36: 113-120
• 49 Buchbender C, Heusner TA, Lauenstein TC. et al. Oncologic PET/MRI, Part 1: Tumors of the Brain, Head and Neck, Chest, Abdomen, and Pelvis. J Nucl Med 2012; 53: 928-938
• 50 Loeffelbein DJ, Souvatzoglou M, Wankerl V. et al. PET-MRI Fusion in Head-and-Neck Oncology: Current Status and Implications for Hybrid PET/MRI. Journal of Oral and Maxillofacial Surgery 2012; 70: 473-483
• 51 Pichler BJ, Kolb A, Nägele T. et al. PET/MRI: Paving the Way for the Next Generation of Clinical Multimodality Imaging Applications. J Nucl Med 2010; 51: 333-336
• 52 Boss A, Stegger L, Bisdas S. et al. Feasibility of simultaneous PET/MR imaging in the head and upper neck area. Eur Radiol 2011; 21: 1439-1446
• 53 Partovi S, Kohan A, Vercher-Conejero JL. et al. Qualitative and Quantitative Performance of 18F-FDG-PET/MRI versus 18F-FDG-PET/CT in Patients with Head and Neck Cancer. American Journal of Neuroradiology 2014; 35: 1970-1975
• 54 Comoretto M, Balestreri L, Borsatti E. et al. Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy: comparison of MR imaging and FDG PET/CT. Radiology 2008; 249: 203-211
• 55 Engelbrecht V, Pisar E, Fürst G. et al. Verlaufskontrolle und Rezidivdiagnostik maligner Kopf- und Halstumoren nach Radiochemotherapie. Fortschr Röntgenstr 1995; 162: 304-310
• 56 Lell M, Baum U, Greess H. et al. Head and neck tumors: imaging recurrent tumor and post-therapeutic changes with CT and MRI. European Journal of Radiology 2000; 33: 239-247
• 57 Queiroz MA, Hüllner M, Kuhn F. et al. PET/MRI and PET/CT in follow-up of head and neck cancer patients. Eur J Nucl Med Mol Imaging 2014; 41: 1066-1075
• 58 León X, Quer M, Diez S. et al. Second neoplasm in patients with head and neck cancer. Head Neck 1999; 21: 204-210
• 59 Goeckenjan G, Sitter H, Thomas M. et al. Prevention, Diagnosis, Therapy, and Follow-up of Lung Cancer. Pneumologie 2011; 65: 39-59
• 60 Raad RA, Friedman KP, Heacock L. et al. Outcome of small lung nodules missed on hybrid PET/MRI in patients with primary malignancy. J Magn Reson Imaging 2016; 43: 504-511
• 61 Sawicki LM, Grueneisen J, Buchbender C. et al. Evaluation of the Outcome of Lung Nodules Missed on 18F-FDG PET/MRI Compared with 18F-FDG PET/CT in Patients with Known Malignancies. J Nucl Med 2016; 57: 15-20
• 62 Sawicki LM, Grueneisen J, Buchbender C. et al. Comparative Performance of 18F-FDG PET/MRI and 18F-FDG PET/CT in Detection and Characterization of Pulmonary Lesions in 121 Oncologic Patients. J Nucl Med 2016; 57: 582-586
• 63 Heusch P, Buchbender C, Köhler J. et al. Thoracic staging in lung cancer: prospective comparison of 18F-FDG PET/MR imaging and 18F-FDG PET/CT. J Nucl Med 2014; 55: 373-378
• 64 Schaarschmidt B, Buchbender C, Gomez B. et al. Thoracic staging of non-small-cell lung cancer using integrated 18F-FDG PET/MR imaging: diagnostic value of different MR sequences. Eur J Nucl Med Mol Imaging 2015; 42: 1257-1267
• 65 Huellner MW, de Barbosa FG, Husmann L. et al. TNM Staging of Non-Small Cell Lung Cancer: Comparison of PET/MR and PET/CT. J Nucl Med 2016; 57: 21-26
• 66 Schaarschmidt BM, Grueneisen J, Metzenmacher M. et al. Thoracic staging with 18F-FDG PET/MR in non-small cell lung cancer – does it change therapeutic decisions in comparison to 18F-FDG PET/CT?. Eur Radiol 2017; 27: 681-688
• 67 Lee GIH, Kim SJ. et al. Clinical Implication of PET/MR Imaging in Preoperative Esophageal Cancer Staging: Comparison with PET/CT, Endoscopic Ultrasonography, and CT. J Nucl Med 2014; 55: 1242-1247
• 68 Quick HH. Integrated PET/MR. J Magn Reson Imaging 2014; 39: 243-258
• 69 Stumpp P, Purz S, Sabri O. et al. Molekulare Bildgebung bei Kopf‐ Hals‐Tumoren. Radiologe 2016; 56: 588-596
• 70 Gawlitza M, Purz S, Kubiessa K. et al. In Vivo Correlation of Glucose Metabolism, Cell Density and Microcirculatory Parameters in Patients with Head and Neck Cancer: Initial Results Using Simultaneous PET/MRI. PLoS One 2015; 10: e0134749
• 71 Surov A, Stumpp P, Meyer HJ. et al. Simultaneous 18F-FDG-PET/MRI: Associations between diffusion, glucose metabolism and histopathological parameters in patients with head and neck squamous cell carcinoma. Oral Oncology 2016; 58: 14-20
• 72 Loktev A, Lindner T, Mier W. et al. A Tumor-Imaging Method Targeting Cancer-Associated Fibroblasts. J Nucl Med 2018; 59: 1423-1429
• 73 Loktev A, Lindner T, Burger EM. et al. Development of Fibroblast Activation Protein-Targeted Radiotracers with Improved Tumor Retention. J Nucl Med 2019; 60: 1421-1429
• 74 Giesel FL, Kratochwil C, Lindner T. et al. 68Ga-FAPI PET/CT: Biodistribution and Preliminary Dosimetry Estimate of 2 DOTA-Containing FAP-Targeting Agents in Patients with Various Cancers. J Nucl Med 2019; 60: 386-392
• 75 Schaarschmidt BM, Gomez B, Buchbender C. et al. Is integrated 18FFDG PET/MRI superior to 18F-FDG PET/CT in the differentiation of incidental tracer uptake in the head and neck area?. Diagn Interv Radiol 2017; 23: 127-132