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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Positron emission tomography with 18fluor-2-deoxy-D-glucose (FDG-PET) is increasingly used in clinical practice, especially in oncology. However, in the Netherlands, guidelines for its routine use are lacking, probably due to the limited availability and costs of PET technology. The increasing demand for evidence of a positive effect on patient management (and outcome) following the introduction of new diagnostic tests, also plays an important role. For non-small cell lung cancer (NSCLC) such evidence is now available. In a prospective randomised multicentre study performed in the Comprehensive Cancer Centre in Amsterdam, FDG-PET reduced the number of futile thoracotomies in patients with suspected NSCLC by 50%. This and other studies resulted in a regional guideline (formulated by pulmonologists, surgeons, radiotherapists, radiologists and nuclear medicine physicians) for the use of FDG-PET in patients with (suspected) NSCLC. Several, predominantly multicentre, studies to evaluate the effectiveness of FDG-PET in subgroups of patients with colorectal cancer, breast cancer, oesophageal cancer, ENT tumours, non-Hodgkin's lymphoma and NSCLC (early in the diagnostic workup), are currently being undertaken in the Netherlands. The results of these might facilitate a cost-effective positioning of PET technology for routine patient care in the Netherlands. A recent report from the Comprehensive Cancer Centre in the south of the Netherlands, based on scenarios in Belgium and the United States, indicates that the availability of PET facilities should increase substantially over the next decade, so as to ensure access to all patients who may benefit from this technology.
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PMID:[Positron emission tomography in the Netherlands: need to expand the capacity]. 1238 64

Experience in our and other institutions with PET/CT imaging of lung and head and neck cancers has shown that this new modality has higher specificity and sensitivity than PET alone and in certain settings even when compared to PET and CT viewed side by side. The largest experience exists with non-small cell lung cancer (NSCLC), in which it has been demonstrated that PET/CT is superior to PET and CT in T and in N staging. Superiority in M staging has yet to be demonstrated. CT contrast media enhancement is probably only necessary when a substantial mediastinal tumor component is present. In such cases, delineation of tumor from vascular structures is relevant. In ENT tumors, PET/CT also appears to be superior to PET, and probably also to PET and CT viewed side by side. Early information suggests that contrast media enhancement for staging may not be required, but the data available is still limited. In both settings, it is interesting to note that in a number of patients, second metachronous tumors are discovered with PET/CT, mainly localized in the GI tract.
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PMID:Why most PET of lung and head-and-neck cancer will be PET/CT. 1473 37