Head and neck cancer therapy response interpretation (Hopkins criteria)

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The head and neck cancer therapy response interpretation (Hopkins criteria) is a qualitative system of interpretation for therapy response assessment using PET-CT.

Background

Widely used options for therapy response assessment are clinical examination, histopathology, CT and MR imaging, however, they have variable diagnostic accuracy . Fluorine-18-FDG PET-CT is useful in the diagnosis, staging, therapy assessment, and follow-up of head and neck squamous cell carcinoma (HNSCC) . Pretreatment F-18-FDG PET-CT is useful in accurate staging and prediction of disease recurrence as well as survival .  Post-treatment F-18-FDG PET-CT is useful in evaluating treatment response, detecting recurrence , predicting outcomes and survival .

These criteria have substantial interreader agreement, high negative predictive value, and can predict overall survival and progression-free survival in patients with HNSCC .

Criteria

Five-point qualitative post-therapy assessment scoring system (Hopkins criteria) for head and neck PET-CT:

  • Response category F-18-FDG uptake at the primary site and nodes less than internal jugular vein (IJV). Complete metabolic response.
  • Focal F-18-FDG uptake at the primary site and nodes greater than IJV but less than liver. Likely complete metabolic response.
  • Diffuse F-18-FDG uptake at the primary site or nodes is greater than IJV or liver. Likely postradiation inflammation.
  • Focal F-18-FDG uptake at the primary site or nodes greater than liver. Likely residual tumor.
  • Focal and intense F-18-FDG uptake at the primary site or nodes. Residual tumor.