Head and Neck Cancer Soft Tissue Radiation Necrosis - Diagnostic Challenge

Darko Pucar; Michael W. Groves; Paul Biddinger; Ramon Figueroa; Hadyn T. Williams

doi:10.1097/RLU.0000000000002356

Head and Neck Cancer Soft Tissue Radiation Necrosis - Diagnostic Challenge

Darko Pucar, Michael W. Groves, Paul Biddinger, Ramon Figueroa, Hadyn T. Williams

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

A 53-year-old man with T4aN2cM0 tongue base squamous cell carcinoma received definitive chemoradiation. FDG PET/CT at 6 weeks showed partial metabolic response with soft tissue air indicating radiation necrosis at primary site and complete response in the neck. At 9 weeks, contrasted CT showed worsening but nonenhancing ulceration, area biopsied demonstrating a minute carcinoma focus with treatment effect. At 12 weeks, PET/CT showed increased primary site uptake interpreted as disease progression; however, no viable tumor was found at salvage surgery. Because nonenhancing ulceration predicts pure radiation necrosis with no viable tumor, contrasted CT may guide treatment selection in challenging cases.

Original language	English (US)
Pages (from-to)	e110-e112
Journal	Clinical nuclear medicine
Volume	44
Issue number	2
DOIs	https://doi.org/10.1097/RLU.0000000000002356
State	Published - Feb 1 2019

Keywords

FDG PET/CT
contrasted CT
head and neck cancer
radiation necrosis
soft tissue

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/RLU.0000000000002356

Cite this

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title = "Head and Neck Cancer Soft Tissue Radiation Necrosis - Diagnostic Challenge",

abstract = "A 53-year-old man with T4aN2cM0 tongue base squamous cell carcinoma received definitive chemoradiation. FDG PET/CT at 6 weeks showed partial metabolic response with soft tissue air indicating radiation necrosis at primary site and complete response in the neck. At 9 weeks, contrasted CT showed worsening but nonenhancing ulceration, area biopsied demonstrating a minute carcinoma focus with treatment effect. At 12 weeks, PET/CT showed increased primary site uptake interpreted as disease progression; however, no viable tumor was found at salvage surgery. Because nonenhancing ulceration predicts pure radiation necrosis with no viable tumor, contrasted CT may guide treatment selection in challenging cases.",

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AU - Pucar, Darko

AU - Groves, Michael W.

AU - Biddinger, Paul

AU - Figueroa, Ramon

AU - Williams, Hadyn T.

PY - 2019/2/1

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AB - A 53-year-old man with T4aN2cM0 tongue base squamous cell carcinoma received definitive chemoradiation. FDG PET/CT at 6 weeks showed partial metabolic response with soft tissue air indicating radiation necrosis at primary site and complete response in the neck. At 9 weeks, contrasted CT showed worsening but nonenhancing ulceration, area biopsied demonstrating a minute carcinoma focus with treatment effect. At 12 weeks, PET/CT showed increased primary site uptake interpreted as disease progression; however, no viable tumor was found at salvage surgery. Because nonenhancing ulceration predicts pure radiation necrosis with no viable tumor, contrasted CT may guide treatment selection in challenging cases.

KW - FDG PET/CT

KW - contrasted CT

KW - head and neck cancer

KW - radiation necrosis

KW - soft tissue

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Head and Neck Cancer Soft Tissue Radiation Necrosis - Diagnostic Challenge

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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