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.
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.
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.
- 1. Clavel S, Charron MP, Belair M, et al. The role of computed tomography in the management of the neck after chemoradiotherapy in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2012;82:567–573.
- 2. Vandecaveye V, De Keyzer F, Nuyts S, et al. Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo)radiotherapy: correlation between radiologic and histopathologic findings. Int J Radiat Oncol Biol Phys. 2007;67:960–971.
- 3. Dibble EH, Alvarez AC, Truong MT, Mercier G, Cook EF, Subramaniam RM. 18F-FDG metabolic tumor volume and total glycolytic activity of oral cavity and oropharyngeal squamous cell cancer: adding value to clinical staging. J Nucl Med. 2012;53:709–715.
- 4. Paidpally V, Tahari AK, Lam S, et al. Addition of 18F-FDG PET/CT to clinical assessment predicts overall survival in HNSCC: a retrospective analysis with follow-up for 12 years. J Nucl Med. 2013;54:2039–2045.
- 5. Joo YH, Yoo IR, Cho KJ, et al. Prognostic value of preoperative F-FDG PET/CT for primary head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol. 2014;271:1685–1691.
- 6. Gupta T, Master Z, Kannan S, et al. Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2011;38:2083–2095.
- 7. Sherriff JM, Ogunremi B, Colley S, Sanghera P, Hartley A. The role of positron emission tomography/CT imaging in head and neck cancer patients after radical chemoradiotherapy. Br J Radiol. 2012;85:e1120–e1126.
- 8. Cashman EC, MacMahon PJ, Shelly MJ, Kavanagh EC. Role of positron emission tomography–computed tomography in head and neck cancer. Ann Otol Rhinol Laryngol. 2011;120:593–602.
- 9. Marcus C, Ciarallo A, Tahari A, Mena E, Koch W, Wahl R, Kiess A, Kang H, Subramaniam R. Head and Neck PET/CT: Therapy Response Interpretation Criteria (Hopkins Criteria) −Interreader Reliability, Accuracy, and Survival Outcomes. J Nucl Med. 2014;55:1411-1416.
- 10. Sankaranarayanan R, Masuyer E, Swaminathan R, Ferlay J, Whelan S. Head and neck cancer: a global perspective on epidemiology and prognosis. (1998) Anticancer research. 18 (6B): 4779-86. Pubmed