CC BY-NC-ND 4.0 · Laryngorhinootologie 2021; 100(S 02): S27
DOI: 10.1055/s-0041-1727666
Abstracts
Imaging / Sonography: Neck

Comparison of imaging in lymph node staging after primary radio- or radiochemotherapy of advanced head and neck cancer - First insights of the prospective-multicentric HN-Onkoimage-1-trial

J Künzel
1   Universitätsklinikum Regensburg, Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Regensburg
,
A Bozzato
2   Universitätsklinikum des Saarlandes, Klinik und Poliklinik für Hals, -Nasen- und Ohrenheilkunde, Homburg
,
M Miederer
3   Universitätsmedizin Mainz, Klinik und Poliklinik für Nuklearmedizin, Mainz
,
G Wirth
4   Universitätsmedizin Mainz, Klink und Poliklinik für Neuroradiologie, Mainz
,
J Grosse
5   Universitätsklinikum Regensburg, Abteilung für Nuklearmedizin, Regensburg
,
C Bohr
1   Universitätsklinikum Regensburg, Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Regensburg
,
J Rennert
6   Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
,
J Hagemann
7   Universitätsmedizin Mainz, Hals-, Nasen-, Ohrenklinik und Poliklinik, Mainz
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    Introduction A salvage neck dissection (ND) after primary radio(chemo)therapy (RCT) of advanced HNSCC should be reserved for patients with a vital residual tumor. In this regard, the predictive power of various imaging systems has not been sufficiently clarified. Within the scope of this study, the importance of different imaging systems for re-staging 3 months after RCT is to be examined further. The results of the interobserver validation (IOV) are described in relation to problems of the study implementation and evaluation.

    Material and Method Design: prospective, multicenter. Inclusion: ED HNSCC cN+; RCT, p16 status; age> 18. Exclusion: KM allergy; palliative situation after RCT; surgical capability for ND not given; ECOG> 2; Ethics Committee LAEK RLP 2018-13274_4; DRKS 00013900. Re-staging 3 and 9-12 months after RCT respectively. Endpoints: Sens, Spec, PPW, NPW and misclassification rate, as well as pairwise comparisons of US, CT, PET/CT in the assessment of N0 vs. N +.

    Results From 06/18-05/20 n=40 patients were included. n=36 achieved the 1st re-staging; n=4 ND. Despite the study protocol, the IOV of the US findings showed limitations of reproducibility, the IOV of the CT inaccuracies in the case of residuals that were difficult to define metrically. In the PET/CT quantitative measurement of SUVmax/peak in lesions without increased nuclide uptake and the application of the Hopkins scale proved to be difficult. Different PET protocols and scanners limit the comparability.

    Discussion The interim evaluation showed the difficulties of a standardized protocol for implementation and evaluation, including IOV, of various imaging modalities, especially in the case of multicenter implementation. The evaluation of the results is planned by the end of 2021.

    Poster-PDF A-1226.pdf

    DEGUM e.V.


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    Conflict of interest

    Der Erstautor gibt keinen Interessenskonflikt an.

    Address for correspondence

    PD Dr. med. Künzel Julian
    Universitätsklinikum Regensburg, Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde
    Franz-Josefstraussallee 11
    93053 Regensburg

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    Artikel online veröffentlicht:
    13. Mai 2021

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