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The overlapping risk factors for lung and head and neck cancer present a definite risk of synchronous malignant pathology. This is the first study to specifically review incidental positron emission tomography computed tomography findings in the head and neck region in lung carcinoma patients.
Methods:
A retrospective review was performed of all lung cancer patients who underwent positron emission tomography computed tomography imaging over a five-year period (January 2008 – December 2012), identified from the Liverpool thoracic multidisciplinary team database.
Results:
Six hundred and nine patients underwent positron emission tomography computed tomography imaging over this period. In 76 (12.5 per cent) scans, incidental regions of avid 18F-fluoro-deoxy-glucose uptake were reported in the head and neck region. In the 28 patients who were fully investigated, there were 4 incidental findings of malignancy.
Conclusion:
In lung cancer patients undergoing investigative positron emission tomography computed tomography scanning, a significant number will also present with areas of clinically significant 18F-fluoro-deoxy-glucose uptake in the head and neck region. Of these, at least 5 per cent may have an undiagnosed malignancy.
Positron emission tomography (PET) and more recently PET/computed tomography (CT) has been utilized as a measure of functional imaging for many decades. The manufacture of PET radiotracers for imaging molecular processes in the human brain begins with the production of the PET radioisotope using a cyclotron. A nuclear reaction takes place in the target between the particle and the atom of the target material that gives rise to the PET radioisotope. The radioisotope is then sent to the radiopharmacy where it is used in the preparation of a radiopharmaceutical. Different patient protocols for PET imaging with 18F fluorodeoxyglucose (18F-FDG) are present for oncological and cardiac indications. PET regional cerebral blood flow (rCBF) imaging with 15O-water can be quantified using a mathematical model using a diffusible tracer technique method. Software has been developed to assess imaging more quantitatively with comparison to normal subjects.
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