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PET scanning and Gamma Knife® radiosurgery in the early diagnosis and salvage "cure" of locally recurrent nasopharyngeal carcinoma

Departments of ¹ Radiotherapy, ² Ear, Nose and Throat, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK

View larger version (73K): [in this window] [in a new window]   Figure 1. A positron emission tomography(PET)-CT scan performed in March 2004. Fluorodeoxyglucose (FDG)-PET and CT axial images through the nasopharynx demonstrate increased FDG uptake in an area corresponding to the roof of the nasopharynx. The area of uptake shown was subsequently biopsied and confirmed as an area of persistent/recurrent nasopharyngeal carcinoma.

View larger version (108K): [in this window] [in a new window]   Figure 2. An axial MRI slice through the nasopharynx. The MRI scan is acquired with the patient secured in the stereotactic frame. Computer programs use these images to develop a treatment plan. Outlined in red is the target volume delineated using the MRI and PET-CT data. In yellow is the 50% isodose that conforms to the target, with 95% of the target receiving at least 14 Gy.

View larger version (70K): [in this window] [in a new window]   Figure 3. A CT-PET (positron emission tomography) scan performed in May 2006 demonstrating no areas of focal fluorodeoxyglucose uptake through the level corresponding to the previous area of recurrence.