Combined SPECT/CT improves detection of initial bone invasion and determination of resection margins in squamous cell carcinoma of the head and neck compared to conventional imaging modalities.

Abstract

A longitudionally evaluated group of 30 patients with biopsy-proven HNSCC adjacent to the mandible underwent 99mTc-bisphosphonate SPECT/CT, MRI, MSCT and conventional radiography before partial or rim resection of the mandible was performed. In conclusion hybrid SPECT/CT was shown to have a higher specificity as it provided additional information about the existence and local extent of malignant bone infiltration of the madible. The sensitivivity of conventional SPECT is similar to that of SPECT/CT but the latter provides a much better delineation of the local tumour-bone contact area. Based on this information, surgical intervention of the rim versus partial resection can be planned and performed more precisely. Patient outcome can be improved by avoiding undertreatment and unnecessary or overextended bone resections.