Head and neck cancer therapy response interpretation (Hopkins criteria)

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 ^1,2. Fluorine-18-FDG PET-CT is useful in the diagnosis, staging, therapy assessment, and follow-up of head and neck squamous cell carcinoma (HNSCC) ^3,4. Pretreatment F-18-FDG PET-CT is useful in accurate staging and prediction of disease recurrence as well as survival ⁵.  Post-treatment F-18-FDG PET-CT is useful in evaluating treatment response, detecting recurrence ⁶, predicting outcomes and survival ^7,8.

These criteria have substantial interreader agreement, high negative predictive value, and can predict overall survival and progression-free survival in patients with HNSCC ⁹.

Criteria

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

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