PET/CT in the evaluation of hypoxia for radiotherapy planning in head and neck tumors: systematic literature review

Abstract

Introduction: PET/CT combines the molecular with the anatomical level which, with the administration of a hypoxia-sensitive radiopharmaceutical, allows the evaluation of tissue oxygenation. Materials and Methods: The work consists of a systematic literature review, including electronic addresses, books and articles dated from July 1997 to December 2019. The aim of this work is to identify the best suited PET radiopharmaceuticals for the detection of cell hypoxia and recognize the benefits for treatment planning with IMRT/VMAT techniques. Results: Hypoxia affects the likelihood cure of head and neck tumors, thereby reducing the success rate. Radiopharmaceuticals such as ¹⁸F-FMISO, ¹⁸F-FETNIM and ¹⁸F-HX4 allow the delineation of hypoxic subvolumes within the target volume to optimize IMRT/VMAT treatment. Discussion: The identification of hypoxia areas with PET/CT imaging and subsequent treatment with IMRT/VMAT allows a possible radiation dose escalation in radioresistant subvolumes. Conclusion: There is a decrease in relapses and an increased likelihood of disease-free survival.