An Imager's Guide to Perineural Tumor Spread in Head and Neck Cancers: Radiologic Footprints on 18F-FDG PET, with CT and MRI Correlates

被引：38

作者：

Lee, Hwan ^{[1
]}

Lazor, Jillian W. ^{[2
]}

Assadsangabi, Reza ^{[1
]}

Shah, Jagruti ^{[1
]}

机构：

[1] Univ Penn, Dept Radiol, Div Nucl Med & Clin Mol Imaging, Philadelphia, PA 19104 USA

[2] Univ Penn, Dept Radiol, Div Neuroradiol, Philadelphia, PA 19104 USA

来源：

JOURNAL OF NUCLEAR MEDICINE | 2019年 / 60卷 / 03期

关键词：

perineural spread; head and neck cancer; cranial nerves; F-18-FDG PET; correlative imaging; ADENOID CYSTIC CARCINOMA; SQUAMOUS-CELL CARCINOMA; POSITRON-EMISSION-TOMOGRAPHY; CLINICAL-SIGNIFICANCE; TRIGEMINAL NERVE; BASAL-CELL; SKULL BASE; INVASION; ANATOMY; EXTENSION;

D O I：

10.2967/jnumed.118.214312

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

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 F-18-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, F-18-FDG PET shows both abnormality along the course of the involved nerve and muscular changes secondary to denervation. Assessment of PNS on F-18-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.

引用

页码：304 / 311

页数：8