Pub Date : 2025-11-14DOI: 10.1016/S0928-1258(25)00324-9
{"title":"Index des auteurs","authors":"","doi":"10.1016/S0928-1258(25)00324-9","DOIUrl":"10.1016/S0928-1258(25)00324-9","url":null,"abstract":"","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 341-342"},"PeriodicalIF":0.2,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-14DOI: 10.1016/S0928-1258(25)00325-0
{"title":"Index des mots-cles","authors":"","doi":"10.1016/S0928-1258(25)00325-0","DOIUrl":"10.1016/S0928-1258(25)00325-0","url":null,"abstract":"","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 343-347"},"PeriodicalIF":0.2,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.mednuc.2025.09.005
S. Querellou-Lefranc , O-F. Couturier , C. Quere , V. Devauchelle-Pensec
Fluorodeoxyglucose positron emission tomography (FDG-PET) is increasingly studied as a diagnostic and monitoring tool in chronic inflammatory diseases, particularly inflammatory rheumatisms. This article provides a comprehensive review of its main indications and limitations, based on a multidisciplinary session involving both clinician and nuclear medicine specialist. Each rheumatologic entity – rheumatoid arthritis, spondyloarthritis, crystal-induced arthropathies, and polymyalgia rheumatica (PMR) – is discussed in terms of clinical presentation, diagnostic challenges, and the potential benefits of FDG-PET imaging. The analysis highlights the added value of FDG-PET in PMR, especially for differential diagnosis and patient stratification, as well as the recent development of interpretation scores. Conversely, evidence remains inconclusive for RA and SpA, and limited for microcrystalline diseases. The article concludes with future perspectives including new radiotracers and integrated clinical-imaging approaches.
{"title":"Place de la TEP-FDG dans les rhumatismes inflammatoires chroniques : une revue clinique et imagerie croisée","authors":"S. Querellou-Lefranc , O-F. Couturier , C. Quere , V. Devauchelle-Pensec","doi":"10.1016/j.mednuc.2025.09.005","DOIUrl":"10.1016/j.mednuc.2025.09.005","url":null,"abstract":"<div><div>Fluorodeoxyglucose positron emission tomography (FDG-PET) is increasingly studied as a diagnostic and monitoring tool in chronic inflammatory diseases, particularly inflammatory rheumatisms. This article provides a comprehensive review of its main indications and limitations, based on a multidisciplinary session involving both clinician and nuclear medicine specialist. Each rheumatologic entity – rheumatoid arthritis, spondyloarthritis, crystal-induced arthropathies, and polymyalgia rheumatica (PMR) – is discussed in terms of clinical presentation, diagnostic challenges, and the potential benefits of FDG-PET imaging. The analysis highlights the added value of FDG-PET in PMR, especially for differential diagnosis and patient stratification, as well as the recent development of interpretation scores. Conversely, evidence remains inconclusive for RA and SpA, and limited for microcrystalline diseases. The article concludes with future perspectives including new radiotracers and integrated clinical-imaging approaches.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 330-336"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.mednuc.2025.09.002
V. Tissot
Magnetic resonance imaging (MRI) plays a key role in the initial evaluation of squamous cell carcinomas of the upper aerodigestive tract (UADT), especially for supraglottic and oral locations. Thanks to its high soft tissue contrast and multiparametric capabilities, MRI provides precise analysis of deep spaces, tumor extension, bone and perineural invasion, and nodal involvement. This article reviews relevant radiologic anatomy, key MRI sequences, their interpretation, and technical limitations. Clinical cases illustrate diverse tumor presentations such as lingual, tonsillar, and parapharyngeal lesions. Despite being susceptible to artifacts, MRI remains a reference imaging modality in many supraglottic regions for staging, lesion characterization, and operability assessment. A structured reporting approach is also presented, integrating the TNM classification and unresectability criteria.
{"title":"Apports de l’IRM dans le bilan initial des carcinomes épidermoïdes des voies aérodigestives supérieures (VADS)","authors":"V. Tissot","doi":"10.1016/j.mednuc.2025.09.002","DOIUrl":"10.1016/j.mednuc.2025.09.002","url":null,"abstract":"<div><div>Magnetic resonance imaging (MRI) plays a key role in the initial evaluation of squamous cell carcinomas of the upper aerodigestive tract (UADT), especially for supraglottic and oral locations. Thanks to its high soft tissue contrast and multiparametric capabilities, MRI provides precise analysis of deep spaces, tumor extension, bone and perineural invasion, and nodal involvement. This article reviews relevant radiologic anatomy, key MRI sequences, their interpretation, and technical limitations. Clinical cases illustrate diverse tumor presentations such as lingual, tonsillar, and parapharyngeal lesions. Despite being susceptible to artifacts, MRI remains a reference imaging modality in many supraglottic regions for staging, lesion characterization, and operability assessment. A structured reporting approach is also presented, integrating the TNM classification and unresectability criteria.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 303-307"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.mednuc.2025.09.003
U. Schick , R. Abgral , V. Tissot , O.-F. Couturier , J.-C. Leclere
Radiotherapy remains a key treatment modality for squamous cell carcinomas of the upper aerodigestive tract (UADT), both in definitive and postoperative settings. However, therapeutic standards in head and neck oncology have seen minimal change over the past fifteen years, mainly due to negative clinical trials. However, the field is evolving, aiming to improve treatment precision and personalize protocols. This article presents a comprehensive overview of ongoing advances, the role of intensity-modulated radiotherapy (IMRT, VMAT), the principles of adaptive radiotherapy, the integration of PET-CT into treatment planning and follow-up, the impact of metabolic data on tumor delineation, and the rationale behind current dose-escalation and de-escalation trials. Through a critical analysis of current practice and future perspectives, this article highlights the potential for more precise and individualized radiotherapy in head and neck cancer management.
{"title":"Standards actuels, innovations et perspectives en radiothérapie ORL – Place de la TEP dans les stratégies de développement","authors":"U. Schick , R. Abgral , V. Tissot , O.-F. Couturier , J.-C. Leclere","doi":"10.1016/j.mednuc.2025.09.003","DOIUrl":"10.1016/j.mednuc.2025.09.003","url":null,"abstract":"<div><div>Radiotherapy remains a key treatment modality for squamous cell carcinomas of the upper aerodigestive tract (UADT), both in definitive and postoperative settings. However, therapeutic standards in head and neck oncology have seen minimal change over the past fifteen years, mainly due to negative clinical trials. However, the field is evolving, aiming to improve treatment precision and personalize protocols. This article presents a comprehensive overview of ongoing advances, the role of intensity-modulated radiotherapy (IMRT, VMAT), the principles of adaptive radiotherapy, the integration of PET-CT into treatment planning and follow-up, the impact of metabolic data on tumor delineation, and the rationale behind current dose-escalation and de-escalation trials. Through a critical analysis of current practice and future perspectives, this article highlights the potential for more precise and individualized radiotherapy in head and neck cancer management.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 312-314"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.mednuc.2025.09.006
O. Espitia
Giant Cell Arteritis (GCA), the most common large-vessel vasculitis, poses a significant diagnostic and therapeutic challenge in elderly patients. The recognition of both classical cranial and atypical extracranial forms requires a multidisciplinary approach involving nuclear medicine. This session, bringing together clinicians and imaging specialists, aimed to characterize the role of FDG-PET (18F-fluorodeoxyglucose positron emission tomography) in the spectrum of GCA and polymyalgia rheumatica. Following a review of clinical features and updated recommendations (ACR 2022), the speakers highlighted the diagnostic and prognostic value of PET imaging, particularly in extracranial forms, aortitis, and atypical localizations. The limitations of PET, especially reduced sensitivity under corticosteroids, were addressed. The use of visual (grading) and semi-quantitative scores (TVS, PETVAS) was reviewed, along with the potential of alternative tracers such as FAPI. PET imaging is now emerging as a key component of rapid care pathways, aligned with evolving therapeutic strategies including biologics. This article provides a comprehensive synthesis of current evidence on this topic.
{"title":"Apport de la TEP-FDG dans la prise en charge de l’artérite à cellules géantes : croisement des regards clinique et nucléaire","authors":"O. Espitia","doi":"10.1016/j.mednuc.2025.09.006","DOIUrl":"10.1016/j.mednuc.2025.09.006","url":null,"abstract":"<div><div>Giant Cell Arteritis (GCA), the most common large-vessel vasculitis, poses a significant diagnostic and therapeutic challenge in elderly patients. The recognition of both classical cranial and atypical extracranial forms requires a multidisciplinary approach involving nuclear medicine. This session, bringing together clinicians and imaging specialists, aimed to characterize the role of FDG-PET (18F-fluorodeoxyglucose positron emission tomography) in the spectrum of GCA and polymyalgia rheumatica. Following a review of clinical features and updated recommendations (ACR 2022), the speakers highlighted the diagnostic and prognostic value of PET imaging, particularly in extracranial forms, aortitis, and atypical localizations. The limitations of PET, especially reduced sensitivity under corticosteroids, were addressed. The use of visual (grading) and semi-quantitative scores (TVS, PETVAS) was reviewed, along with the potential of alternative tracers such as FAPI. PET imaging is now emerging as a key component of rapid care pathways, aligned with evolving therapeutic strategies including biologics. This article provides a comprehensive synthesis of current evidence on this topic.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 337-340"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.mednuc.2025.09.007
A. Kas , S. Bombois
In France, neurocognitive disorders affect approximately 1.2 million individuals, including 850,000 with Alzheimer's disease (AD). Patients typically present for first memory consultations at an advanced stage, with a mean Mini-Mental State Examination (MMSE) score below 20. Recent advances in diagnosis have largely relied on the development of biomarkers, particularly cerebrospinal fluid (CSF) analysis and positron emission tomography (PET) imaging. CSF biomarkers enable the detection of amyloid plaques (decreased Aβ42 peptide or abnormal Aβ42/Aβ40 ratio) and phosphorylated Tau proteins (increased), indicative of Alzheimer's pathology (A+/T+ status). Their sensitivity and specificity both exceed 90% for the diagnosis of symptomatic AD. Magnetic resonance imaging (MRI), though routinely used, has variable diagnostic value; hippocampal atrophy, in particular, lacks specificity in atypical forms and in prodromal stages of AD. Fluorodeoxyglucose (FDG) PET imaging, by contrast, can detect early cerebral hypometabolism predictive of clinical progression, and it plays a crucial role in differential diagnosis, especially in frontotemporal lobar degeneration (FTLD) and Lewy body disease (LBD). Amyloid-PET imaging enables in vivo visualization of amyloid deposits with a high negative predictive value. Although it can detect amyloid accumulation years before symptom onset, a positive result does not necessarily indicate active AD. In non-Alzheimer's disorders such as FTLD or parkinsonian syndromes, alternative imaging tools are preferred, including FDG-PET, dopamine transporters scintigraphy or meta-iodo-benzyl-guanidine (MIBG) scintigraphy, depending on clinical suspicion. The diagnostic process follows a structured, phenotype-based sequence in which lumbar puncture, FDG-PET, or amyloid-PET are selected according to clinical presentation, contraindications, or inconclusive results. This structured approach underscores the importance of early, personalized, biomarker-guided diagnosis to optimize patient care and to promote access to disease-modifying therapies targeting pathological lesions in AD.
{"title":"Hiérarchisation des biomarqueurs pour le diagnostic des pathologies neurodégénératives : application à la maladie d’Alzheimer","authors":"A. Kas , S. Bombois","doi":"10.1016/j.mednuc.2025.09.007","DOIUrl":"10.1016/j.mednuc.2025.09.007","url":null,"abstract":"<div><div>In France, neurocognitive disorders affect approximately 1.2 million individuals, including 850,000 with Alzheimer's disease (AD). Patients typically present for first memory consultations at an advanced stage, with a mean Mini-Mental State Examination (MMSE) score below 20. Recent advances in diagnosis have largely relied on the development of biomarkers, particularly cerebrospinal fluid (CSF) analysis and positron emission tomography (PET) imaging. CSF biomarkers enable the detection of amyloid plaques (decreased Aβ42 peptide or abnormal Aβ42/Aβ40 ratio) and phosphorylated Tau proteins (increased), indicative of Alzheimer's pathology (A+/T+ status). Their sensitivity and specificity both exceed 90% for the diagnosis of symptomatic AD. Magnetic resonance imaging (MRI), though routinely used, has variable diagnostic value; hippocampal atrophy, in particular, lacks specificity in atypical forms and in prodromal stages of AD. Fluorodeoxyglucose (FDG) PET imaging, by contrast, can detect early cerebral hypometabolism predictive of clinical progression, and it plays a crucial role in differential diagnosis, especially in frontotemporal lobar degeneration (FTLD) and Lewy body disease (LBD). Amyloid-PET imaging enables in vivo visualization of amyloid deposits with a high negative predictive value. Although it can detect amyloid accumulation years before symptom onset, a positive result does not necessarily indicate active AD. In non-Alzheimer's disorders such as FTLD or parkinsonian syndromes, alternative imaging tools are preferred, including FDG-PET, dopamine transporters scintigraphy or meta-iodo-benzyl-guanidine (MIBG) scintigraphy, depending on clinical suspicion. The diagnostic process follows a structured, phenotype-based sequence in which lumbar puncture, FDG-PET, or amyloid-PET are selected according to clinical presentation, contraindications, or inconclusive results. This structured approach underscores the importance of early, personalized, biomarker-guided diagnosis to optimize patient care and to promote access to disease-modifying therapies targeting pathological lesions in AD.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 319-324"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.mednuc.2025.09.009
R. Abgral , J.-C. Leclere , U. Schick , V. Tissot
[18F]Fluorodeoxyglucose positron emission tomography (FDG-PET) has become a key imaging modality in the management of squamous cell carcinomas of the upper aerodigestive tract (UADT). Its utility spans multiple stages of clinical decision-making. In the initial diagnostic work-up, FDG-PET is indicated for the detection of occult primary tumors in cases of isolated cervical lymphadenopathy, for distant metastasis staging in advanced stages (stage III–IV), and for identifying synchronous primaries. It leads to tumor upstaging in approximately 20% of cases and modifies the therapeutic strategy in a similar proportion, particularly for localized disease. Its diagnostic yield is limited in early-stage tumors without nodal involvement. In the post-treatment setting, FDG-PET provides a highly reliable assessment of therapeutic response, with a negative predictive value approaching 100% when performed at least 12 weeks after the end of radiotherapy. It is also helpful in detecting subclinical recurrence and may be considered in patients with poor initial prognostic features. Systematic integration of FDG-PET into follow-up protocols may increase curative treatment opportunities and, according to retrospective data, improve 3-year overall survival. While still under evaluation, the role of FDG-PET in guiding individualized radiotherapy strategies — such as metabolic boosting or adaptive planning — has not yet demonstrated a clear impact on local-regional control or survival. For local imaging, MRI remains superior to CT in assessing tissue contrast, bone marrow invasion, perineural spread, and lymph node characterization. This educational module, illustrated with interactive clinical case-based multiple choice questions, aims to clarify the validated indications and limitations of this imaging modality at various stages of the care pathway.
{"title":"Place de la tomographie par émission de positons au [18F]FDG des voies aéro-digestives supérieures : cas cliniques QCM","authors":"R. Abgral , J.-C. Leclere , U. Schick , V. Tissot","doi":"10.1016/j.mednuc.2025.09.009","DOIUrl":"10.1016/j.mednuc.2025.09.009","url":null,"abstract":"<div><div>[<sup>18</sup>F]Fluorodeoxyglucose positron emission tomography (FDG-PET) has become a key imaging modality in the management of squamous cell carcinomas of the upper aerodigestive tract (UADT). Its utility spans multiple stages of clinical decision-making. In the initial diagnostic work-up, FDG-PET is indicated for the detection of occult primary tumors in cases of isolated cervical lymphadenopathy, for distant metastasis staging in advanced stages (stage III–IV), and for identifying synchronous primaries. It leads to tumor upstaging in approximately 20% of cases and modifies the therapeutic strategy in a similar proportion, particularly for localized disease. Its diagnostic yield is limited in early-stage tumors without nodal involvement. In the post-treatment setting, FDG-PET provides a highly reliable assessment of therapeutic response, with a negative predictive value approaching 100% when performed at least 12 weeks after the end of radiotherapy. It is also helpful in detecting subclinical recurrence and may be considered in patients with poor initial prognostic features. Systematic integration of FDG-PET into follow-up protocols may increase curative treatment opportunities and, according to retrospective data, improve 3-year overall survival. While still under evaluation, the role of FDG-PET in guiding individualized radiotherapy strategies — such as metabolic boosting or adaptive planning — has not yet demonstrated a clear impact on local-regional control or survival. For local imaging, MRI remains superior to CT in assessing tissue contrast, bone marrow invasion, perineural spread, and lymph node characterization. This educational module, illustrated with interactive clinical case-based multiple choice questions, aims to clarify the validated indications and limitations of this imaging modality at various stages of the care pathway.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 315-318"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.mednuc.2025.09.008
J.-C. Leclere , U. Schick , V. Tissot , R. Abgral
Squamous cell carcinomas of the upper aerodigestive tract (UADT) represent a major public health issue, particularly in Brittany, a region with a high incidence. Morphological and functional imaging plays a key role in their management. Large-scale, single-center retrospective studies conducted at Brest University Hospital have assessed the impact of 18F-FDG PET/CT on initial restaging and routine follow-up of head and neck cancers. For initial staging, a cohort of 477 patients was analyzed, all of whom underwent PET in addition to the conventional work-up. The results showed a modification of the TNM classification (including the discovery of synchronous cancers) in 46 % of cases, with 20 % having a moderate or major therapeutic impact. PET restaging had a significant effect on 3-year overall survival, independently of the initial stage or treatment escalation/de-escalation strategies. For follow-up, in a case-control cohort of 782 patients, PET demonstrated excellent diagnostic performance (regardless of the post-treatment interval), notably with a negative predictive value greater than 98 %, and enabled early detection of subclinical recurrences and metachronous cancers. A significant improvement in 3-year overall survival was observed in the group monitored with PET, and this was confirmed in an external validation cohort. These findings support a more systematic use of PET in initial management, particularly for patients at high risk of recurrence, and suggest the value of imaging follow-up during the first two years. The main limitations lie in the retrospective nature of the studies and the current lack of consensus guidelines in the initial work up of early stages. This article presents only the principal results of these studies, which are the subject of an original publication.
{"title":"Contribution du TEP-TDM au 18FDG à la prise en charge initiale et à la surveillance des carcinomes épidermoïdes des VADS : le point de vue du chirurgien","authors":"J.-C. Leclere , U. Schick , V. Tissot , R. Abgral","doi":"10.1016/j.mednuc.2025.09.008","DOIUrl":"10.1016/j.mednuc.2025.09.008","url":null,"abstract":"<div><div>Squamous cell carcinomas of the upper aerodigestive tract (UADT) represent a major public health issue, particularly in Brittany, a region with a high incidence. Morphological and functional imaging plays a key role in their management. Large-scale, single-center retrospective studies conducted at Brest University Hospital have assessed the impact of 18F-FDG PET/CT on initial restaging and routine follow-up of head and neck cancers. For initial staging, a cohort of 477 patients was analyzed, all of whom underwent PET in addition to the conventional work-up. The results showed a modification of the TNM classification (including the discovery of synchronous cancers) in 46 % of cases, with 20 % having a moderate or major therapeutic impact. PET restaging had a significant effect on 3-year overall survival, independently of the initial stage or treatment escalation/de-escalation strategies. For follow-up, in a case-control cohort of 782 patients, PET demonstrated excellent diagnostic performance (regardless of the post-treatment interval), notably with a negative predictive value greater than 98 %, and enabled early detection of subclinical recurrences and metachronous cancers. A significant improvement in 3-year overall survival was observed in the group monitored with PET, and this was confirmed in an external validation cohort. These findings support a more systematic use of PET in initial management, particularly for patients at high risk of recurrence, and suggest the value of imaging follow-up during the first two years. The main limitations lie in the retrospective nature of the studies and the current lack of consensus guidelines in the initial work up of early stages. This article presents only the principal results of these studies, which are the subject of an original publication.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 308-311"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-08DOI: 10.1016/j.mednuc.2025.09.001
R. Abgral , J.-C. Leclere , V. Tissot , U. Schick , O.-F. Couturier
18F-fluorodeoxyglucose Positron emission tomography (FDG-PET) has profoundly transformed the management of cancers of the upper aerodigestive tract (UADT), notably due to its performance in detecting metastases, its ability to guide therapeutic decisions after restaging, and its increasing role in post-treatment surveillance. Its use is based on guidelines first established in 2002, which have evolved with research advances and technological innovations up to the most recent publications in 2018. Interpreting PET images in the head and neck area remains complex and is subject to numerous pitfalls — whether physiological, due to intercurrent pathological conditions, or related to artifacts. These factors may lead to false positives or negatives results, potentially impacting clinical decision-making. This article aims to summarize these challenges, provide a comprehensive review of the current indications for FDG-PET in UADT cancers (initial staging, therapeutic evaluation, recurrence detection, and surveillance), and explore future perspectives offered by technological innovations such as LAFOV PET and PET-MRI.
{"title":"Rôle de la TEP-FDG dans les cancers des voies aérodigestives supérieures : indications cliniques, pièges diagnostiques et perspectives technologiques","authors":"R. Abgral , J.-C. Leclere , V. Tissot , U. Schick , O.-F. Couturier","doi":"10.1016/j.mednuc.2025.09.001","DOIUrl":"10.1016/j.mednuc.2025.09.001","url":null,"abstract":"<div><div>18F-fluorodeoxyglucose Positron emission tomography (FDG-PET) has profoundly transformed the management of cancers of the upper aerodigestive tract (UADT), notably due to its performance in detecting metastases, its ability to guide therapeutic decisions after restaging, and its increasing role in post-treatment surveillance. Its use is based on guidelines first established in 2002, which have evolved with research advances and technological innovations up to the most recent publications in 2018. Interpreting PET images in the head and neck area remains complex and is subject to numerous pitfalls — whether physiological, due to intercurrent pathological conditions, or related to artifacts. These factors may lead to false positives or negatives results, potentially impacting clinical decision-making. This article aims to summarize these challenges, provide a comprehensive review of the current indications for FDG-PET in UADT cancers (initial staging, therapeutic evaluation, recurrence detection, and surveillance), and explore future perspectives offered by technological innovations such as LAFOV PET and PET-MRI.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 6","pages":"Pages 297-302"},"PeriodicalIF":0.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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