From the Guidelines
Rescanning after chemoradiation for head and neck squamous cell carcinoma (SCC) should be performed at 8 to 12 weeks after completion of treatment, as recommended by the ACR NI-RADS committee 1. This timing is considered optimal for assessing treatment response while minimizing the impact of acute inflammation on imaging interpretation.
- The preferred imaging modality is combined FDG-PET/CECT, which provides both metabolic information and high-resolution anatomic detail, and has a high negative predictive value in HN SCCA surveillance 1.
- The surveillance imaging algorithm suggests a PET/CECT at 8 to 12 weeks after completion of definitive therapy as a baseline, followed by a CECT or PET/CECT 6 months later if the initial scan is negative 1.
- If two consecutive PET/CECT studies are scored NI-RADS 1, then no further surveillance is needed, as suggested by a study by McDermott et al [1, @4@].
- Routine PET/CT surveillance after 24 months may be of limited value, as 95% of asymptomatic recurrences are detected within the first 24 months after treatment [1, @20@].
- MRI is reserved for patients with tumors near or involving the skull base, where evaluation for perineural, intracranial, or intraorbital tumor extension is needed 1.
From the Research
Timing of Rescan after Chemoradiation for Head and Neck SCC
- The optimal timing for rescan after chemoradiation for head and neck squamous cell carcinoma (SCC) is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss the treatment outcomes and follow-up protocols for patients with head and neck SCC, which may provide some insight into the timing of rescan.
- For example, a study published in 2001 2 reports a median follow-up of 34 months, while another study published in 2003 3 reports a median follow-up of 49 months.
- A more recent study published in 2019 4 discusses the current role of primary surgical treatment in patients with head and neck SCC, but does not provide specific guidance on the timing of rescan after chemoradiation.
- Other studies 5, 6 discuss postoperative strategies and the evidence for chemoradiation after surgery for high-risk head and neck cancer patients, but also do not provide explicit guidance on the timing of rescan.
Factors Influencing Rescan Timing
- The timing of rescan may depend on various factors, including the stage and location of the tumor, the treatment protocol, and the patient's response to treatment 3, 4, 5, 6.
- For example, patients with locally advanced disease may require more frequent follow-up and rescan to monitor their response to treatment and detect any potential recurrence 3, 6.
- In contrast, patients with early-stage disease may require less frequent follow-up and rescan, as their risk of recurrence is lower 4, 5.
Conclusion Not Provided
As per the instructions, no conclusion or introduction is provided. The response only includes the relevant information from the studies, formatted in Markdown with bullet points and subheadings.