Technology Insight: PET and PET/CT in head and neck tumor staging and radiation therapy planning

Steven J. Frank, K. S Clifford Chao, David L. Schwartz, Randal S. Weber, Smith Apisarnthanarax, Homer A. Macapinlac

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations


The evolving utilization of functional imaging, mainly 2-[18F] fluoro-2-deoxyglucose (18FDG) imaging, with positron emission tomography (PET) and PET/CT, is profoundly altering head and neck tumor staging approaches, radiation treatment planning, and follow-up management. Tumor-node-metastasis staging with PET/CT has improved the characterization of patient disease versus CT, MRI, or PET alone, thereby affecting patient disease management. Therefore, the utilization of PET/CT is appropriate for head and neck cancer staging in the initial presentation and in the recurrent setting. In the setting of radiation therapy treatment planning, PET-directed tumor volume contouring is not ready for clinical practice without further technological improvements in imaging specificity/sensitivity and resolution. Patient or organ motion might interfere with the accuracy of anatomical co-alignment, and variability in defining the threshold of imaging signals on PET images can affect the contour of the biological tumor volume. The use of PET/CT for staging and detecting both primary and recurrent head and neck cancer is valuable; however, its application in radiation treatment planning should be viewed as investigational.

Original languageEnglish (US)
Pages (from-to)526-533
Number of pages8
JournalNature Clinical Practice Oncology
Issue number10
StatePublished - Oct 2005


  • Head and neck cancer
  • PET/CT
  • Radiation therapy
  • Treatment planning

ASJC Scopus subject areas

  • Oncology


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