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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 1/2009

01-01-2009 | Original Article

Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up

Authors: Shu-Hang Ng, Sheng-Chieh Chan, Tzu-Chen Yen, Joseph Tung-Chieh Chang, Chun-Ta Liao, Sheung-Fat Ko, Feng-Yuan Liu, Shu-Chyn Chin, Kang-Hsing Fan, Cheng-Lung Hsu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2009

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Abstract

Purpose

We prospectively compared PET/CT and conventional imaging for initial staging of nasopharyngeal carcinoma (NPC).

Methods

A total of 111 patients with histologically proven NPC were investigated with PET/CT and conventional imaging (head-and-neck MRI, chest X-ray, abdominal ultrasound, and bone scan) before treatment. The respective findings were reviewed independently and then compared with each other.

Results

With regard to T staging, PET/CT showed a discrepancy with head-and-neck MRI in 36 (32.4%) of the study subjects. With regard to N staging, PET/CT showed a discrepancy with head-and-neck MRI in 15 (13.5%) patients. Among the discordant cases, MRI was superior in demonstrating tumor involvement in the parapharyngeal space, skull base, intracranial area, sphenoid sinus, and retropharyngeal nodes while PET/CT was superior in demonstrating neck nodal metastasis. PET/CT disclosed 13 of 16 patients with distant malignancy compared with four patients disclosed by conventional imaging work-up. The false-positive rate of PET/CT was 18.8%. PET/CT correctly modified M staging in eight patients (7.2%) and disclosed a second primary lung malignancy in one patient (0.9%).

Conclusion

In NPC patients, MRI appears to be superior to PET/CT for the assessment of locoregional invasion and retropharyngeal nodal metastasis. PET/CT is more accurate than MRI for determining cervical nodal metastasis and should be the better reference for the neck status. PET/CT has an acceptable diagnostic yield and a low false-positive rate for the detection of distant malignancy and can replace conventional work-up to this aim. PET/CT and head-and-neck MRI are suggested for the initial staging of NPC patients.
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Metadata
Title
Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up
Authors
Shu-Hang Ng
Sheng-Chieh Chan
Tzu-Chen Yen
Joseph Tung-Chieh Chang
Chun-Ta Liao
Sheung-Fat Ko
Feng-Yuan Liu
Shu-Chyn Chin
Kang-Hsing Fan
Cheng-Lung Hsu
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2009
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-008-0918-7

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