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European Journal of Nuclear Medicine and Molecular Imaging

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01-09-2006 | Original article

Advantages and pitfalls of ¹⁸F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma: comparison with magnetic resonance imaging

Authors: Sheng-Chieh Chan, Shu-Hang Ng, Joseph Tung-Chieh Chang, Chien-Yu Lin, Yen-Chao Chen, Yu-Chen Chang, Cheng-Lung Hsu, Hung-Ming Wang, Chun-Ta Liao, Tzu-Chen Yen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2006

Abstract

Introduction

This prospective study was designed to elucidate the advantages and pitfalls of ¹⁸F-FDG PET in detecting locally residual/recurrent nasopharyngeal carcinoma (NPC) in comparison with MRI.

Methods

We recruited NPC patients from two ongoing prospective trials. One is being performed to evaluate suspected local recurrence (group A) and the other to assess local treatment response 3 months after therapy (group B). Both groups received ¹⁸F-FDG PET and head and neck MRI. The gold standard was histopathology or clinical/imaging follow-up. An optimal cut-off standardised uptake value (SUV) was retrospectively determined.

Results

From January 2002 to August 2004, 146 patients were eligible. Thirty-four were from group A and 112 from group B. In all, 26 had locally recurrent/residual tumours. Differences in detection rate between ¹⁸F-FDG PET and MRI were not statistically significant in either group. However, ¹⁸F-FDG PET showed significantly higher specificity than MRI in detecting residual tumours among patients with initial T4 disease (p=0.04). In contrast, the specificity of ¹⁸F-FDG PET for patients with an initial T1–2 tumour treated with intracavitary brachytherapy (ICBT) was significantly lower than that for patients not treated by ICBT (72.2% vs 98.1%, p=0.003). At an SUV cut-off of 4.2, PET showed an equal and a higher accuracy compared with MRI in groups A and B, respectively.

Conclusion

¹⁸F-FDG PET is superior to MRI in identifying locally residual NPC among patients with initial T4 disease but demonstrates limitations in assessing treatment response in patients with initial T1–2 disease after ICBT. A cut-off SUV is a useful index for aiding in the visual detection of locally residual/recurrent NPC.

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Title: Advantages and pitfalls of 18F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma: comparison with magnetic resonance imaging
Authors: Sheng-Chieh Chan
Shu-Hang Ng
Joseph Tung-Chieh Chang
Chien-Yu Lin
Yen-Chao Chen
Yu-Chen Chang
Cheng-Lung Hsu
Hung-Ming Wang
Chun-Ta Liao
Tzu-Chen Yen
Publication date: 01-09-2006
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2006
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-005-0054-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Advantages and pitfalls of ¹⁸F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma: comparison with magnetic resonance imaging

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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