Prospective comparison of 18F-NaF PET/CT versus 18F-FDG PET/CT imaging in mandibular extension of head and neck squamous cell carcinoma with dedicated analysis software and validation with surgical specimen. A preliminary study

Publication date: Available online 8 July 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Lopez Raphael, Gantet Pierre, Salabert Anne Sophie, Julian Anne, Hitzel Anne, Herbault-Barres Beatrice, Fontan Charlotte, Alshehri Sarah, Payoux Pierre
Background: The aim of this study is to propose a new method to quantify radioactivity with PET/CT imaging in mandibular extension in head and neck squamous cell carcinoma (HNSCC), using innovative software, and to compare results with microscopic surgical specimens.Patients and MethodsThis prospective study enrolled 15 patients who underwent ¹⁸F-NaF and ¹⁸F-FDG PET/CT. We compared the delineations of bone invasions obtained with ¹⁸F-NaF PET/CT and ¹⁸F-FDG PET/CT with the results of histopathological analysis of mandibular resections (from right and left bone borders). A method for visualization and quantification of PET images was developed.ResultsFor all patients, a significant difference (p = 0.032 for right limits and p = 0.011 for left limits) was observed between ¹⁸F-FDG PET/CT imaging and histopathology results, and no significant difference (p = 0.88 for right limits and p = 0.55 for left limits) was observed between ¹⁸F-NaF PET/CT imaging and histopathology results. The right limits were less than 10 mm in 93% of patients, and the left limits were less than 10 mm in 86% of patients.ConclusionsThe dedicated software enabled the objective delineation of radioactivity within the bone. We can confirm that ¹⁸F-NaF is a precise and specific bone marker for the assessment of intraosseous mandibular extensions of head and neck cancers.CLINICAL QUESTION/LEVEL OF EVIDENCETherapeutic, III.



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