TY - JOUR
T1 - An imager’s guide to perineural tumor spread in head and neck cancers
T2 - Radiologic footprints on 18 F-FDG PET, with CT and MRI correlates
AU - Lee, Hwan
AU - Lazor, Jillian W.
AU - Assadsangabi, Reza
AU - Shah, Jagruti
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Perineural spread (PNS) refers to tumor growth along large nerves, a macroscopic analog of microscopic perineural invasion. This phenomenon most commonly occurs in the head and neck, but its incidence varies with histologic tumor subtype. PNS results from a complex molecular interplay between tumor cells, nerves, and connective stroma. PNS is clinically underdiagnosed despite its impact on patients’ prognosis and management. The role of 18 F-FDG PET in assessment of PNS in head and neck cancer remains to be explored, in contrast to MRI as the established gold standard. In patients with PNS, 18 F-FDG PET shows both abnormality along the course of the involved nerve and muscular changes secondary to denervation. Assessment of PNS on 18 F-FDG PET requires knowledge of relevant neural pathways and can be improved by correlation with anatomic imaging, additional processing of images, and review of clinical context.
AB - Perineural spread (PNS) refers to tumor growth along large nerves, a macroscopic analog of microscopic perineural invasion. This phenomenon most commonly occurs in the head and neck, but its incidence varies with histologic tumor subtype. PNS results from a complex molecular interplay between tumor cells, nerves, and connective stroma. PNS is clinically underdiagnosed despite its impact on patients’ prognosis and management. The role of 18 F-FDG PET in assessment of PNS in head and neck cancer remains to be explored, in contrast to MRI as the established gold standard. In patients with PNS, 18 F-FDG PET shows both abnormality along the course of the involved nerve and muscular changes secondary to denervation. Assessment of PNS on 18 F-FDG PET requires knowledge of relevant neural pathways and can be improved by correlation with anatomic imaging, additional processing of images, and review of clinical context.
KW - F-FDG PET
KW - Correlative imaging
KW - Cranial nerves
KW - Head and neck cancer
KW - Perineural spread
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U2 - 10.2967/jnumed.118.214312
DO - 10.2967/jnumed.118.214312
M3 - Article
C2 - 30291196
AN - SCOPUS:85062397525
VL - 60
SP - 304
EP - 311
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
SN - 0161-5505
IS - 3
ER -