Value of FDG-PET/MR in Oral Focus Assessment in Head and Neck Cancer Patients-A Feasibility Study

Silvio Valdec; Fabienne A Bosshard; Martin Hüllner; Dominic R Schwaninger; Larissa Stocker; Barbara Giacomelli-Hiestand; Bernd Stadlinger

doi:10.3389/fmed.2022.809323

Value of FDG-PET/MR in Oral Focus Assessment in Head and Neck Cancer Patients-A Feasibility Study

Front Med (Lausanne). 2022 Mar 21:9:809323. doi: 10.3389/fmed.2022.809323. eCollection 2022.

Authors

Silvio Valdec^{1

2}, Fabienne A Bosshard¹, Martin Hüllner³, Dominic R Schwaninger¹, Larissa Stocker⁴, Barbara Giacomelli-Hiestand¹, Bernd Stadlinger¹

Affiliations

¹ Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
² Division of Periodontology, Department of Stomatology, Dental School, University of São Paulo, São Paulo, Brazil.
³ Department of Nuclear Medicine, University Hospital Zürich, University of Zurich, Zurich, Switzerland.
⁴ Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

Abstract

FDG-PET/MR is a hybrid imaging modality used for the staging and restaging of advanced head & neck cancer (HNC) patients. Their treatment typically involves radiation therapy, which requires previous dental focus assessment. The aim of this study was to analyze if staging FDG-PET/MR is a valuable tool for oral focus assessment. For this purpose, FDG-PET/MR findings, such as metabolic activity of periapical radiolucencies and marginal periodontitis, were retrospectively compared with conventional standardized dental focus assessment, including dental radiographs and clinical assessment of 124 teeth in seven patients. Increased FDG uptake of periapical lesions was found in one out of 23 lesions. Increased FDG uptake of the marginal periodontium was recorded in one out of 34 lesions. In summary, standardized dental focus assessment by panoramic radiography and periapical radiographs may be enriched by information from FDG-PET/MR, showing active inflammation in dental foci. However, many dental foci have no correlate in FDG-PET/MR. The treatment decision for oral foci may benefit from the visualized presence or absence of metabolic activity on FDG-PET/MR.

Keywords: dental focus; head and neck cancer; panoramic radiography; periapical radiography; positron emission tomography–magnetic resonance imaging; radiation therapy.