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18F-FET PET Compared with 18F-FDG PET and CT in Patients with Head and Neck Cancer

Dirk Pauleit, MD1,2, Andre Zimmermann, MD3, Gabriele Stoffels, MD1, Dagmar Bauer, PhD1, Jörn Risse, MD2, Michael O. Flüss, MD4, Kurt Hamacher, PhD5, Heinz H. Coenen, PhD5 and Karl-Josef Langen, MD1

1 Institute of Medicine and Brain Imaging Center West, Research Center Jülich, Jülich, Germany; 2 GP Nuclear Medicine and Radiology, Bad Honnef, Germany; 3 Department of Cranio- and Maxillofacial Surgery, Heinrich-Heine University, Düsseldorf, Germany; 4 Institute of Radiology, Heinrich-Heine University, Düsseldorf, Germany; and 5 Institute of Nuclear Chemistry, Research Center Jülich, Jülich, Germany


Figure 1
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  		FIGURE 1.  18F-FDG PET (A), CT (B), and 18F-FET PET (C) images of 72-y-old man with SCC of oral cavity (arrows). Tumor exhibits increased uptake of 18F-FDG (SUV, 8.0) and 18F-FET (SUV, 3.6).

 

Figure 2
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  		FIGURE 2.  18F-FDG PET (A), CT (B), and 18F-FET PET (C) images of 52-y-old man with 0.7-cm SCC in 4.3-cm ulcer with inflammatory tissue (arrows). 18F-FDG PET scan shows approximately 4-cm lesion with increased 18F-FDG uptake (SUV, 5.2) that allows no discrimination between carcinoma and inflammation. CT scan demonstrates air-filled ulcer, and 18F-FET PET scan reveals no abnormal 18F-FET uptake (SUV, 1.5), missing the small carcinoma.

 

Figure 3
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  		FIGURE 3.  18F-FDG PET (A), CT (B), and 18F-FET PET (C) images of 50-y-old man with chronic inflammatory tissue (arrows). 18F-FDG PET scan shows lesion with increased 18F-FDG uptake (SUV, 4.7) suggesting malignancy. 18F-FET PET was true negative, with no increased 18F-FET uptake (SUV, 1.3).

 

Figure 4
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  		FIGURE 4.  Composite ROC curves of the 3 observers. Az values for CT, 18F-FET PET, and 18F-FDG PET were 0.82, 0.93, and 0.95, respectively. Accuracy of observers did not significantly differ (P = 0.71) between 18F-FDG and 18F-FET PET but, in the distinction of carcinomas, was significantly (P < 0.05) greater with either technique than with CT.

 




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