Top

Published in:

01-09-2010 | Head and Neck

Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT

Authors: Shu-Hang Ng, Sheng-Chieh Chan, Tzu-Chen Yen, Chun-Ta Liao, Joseph Tung-Chieh Chang, Sheung-Fat Ko, Hung-Ming Wang, Chin-Yu Lin, Kai-Ping Chang, Yu-Chun Lin

Published in: European Radiology | Issue 9/2010

Abstract

Objective

To prospectively compare the diagnostic potential of 3-T whole-body magnetic resonance imaging (WB-MRI) and integrated fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (FDG-PET-CT), and their combined interpretation for the detection of residual/recurrent nasopharyngeal carcinoma (NPC).

Methods

We enrolled 179 NPC patients at high risk of residual disease or with suspected recurrence. WB-MRI and FDG-PET-CT were obtained with an interval of <10 days.

Results

Fifty-five (30.7%) patients were found to have residual/recurrent tumours. In a patient-based analysis, the sensitivity, specificity and diagnostic capability of WB-MRI were similar to those of FDG-PET-CT (90.9% vs. 87.3%, P = 0.69; 91.1% vs. 90.3%, P > 0.99; 0.929 vs. 0.924, P = 0.83, respectively). Combined interpretation of WB-MRI with FDG-PET-CT increased the sensitivity to 94.5%. A slight improvement in the diagnostic capability was obtained using a combined interpretation of WB-MRI and FDG-PET-CT over WB-MRI alone (0.952 vs. 0.929, P = 0.22) and FDG-PET-CT alone (0.952 vs. 0.924, P = 0.11).

Conclusions

Three-Tesla WB-MRI achieved a similar diagnostic capability to FDG-PET-CT for the detection of residual/recurrent NPC. Both techniques have different advantages, and their combined interpretation can yield a slightly higher diagnostic capability. In clinical practice, 3-T WB-MRI can offer an accurate and comprehensive assessment of residual/recurrent NPC.

Koshy M, Paulino AC, Howell R, Schuster D, Halkar R, Davis LW (2005) F-18 FDG PET-CT fusion in radiotherapy treatment planning for head and neck cancer. Head Neck 27:494–502CrossRefPubMed

Zheng XK, Chen LH, Wang QS, Wu FB (2006) Influence of [18F] fluorodeoxyglucose positron emission tomography on salvage treatment decision making for locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 65:1020–1025PubMed

Low JS, Chua ET, Gao F, Wee JT (2006) Stereotactic radiosurgery plus intracavitary irradiation in the salvage of nasopharyngeal carcinoma. Head Neck 28:321–329CrossRefPubMed

Chen MY, Guo X, Wen WP et al (2007) Salvage surgical operation via endoscopic transnasal approach for local persistent or recurrent nasopharyngeal carcinoma. Ai Zheng 26:673–678PubMed

Yen TC, Lin CY, Wang HM et al (2006) 18F-FDG-PET for evaluation of the response to concurrent chemoradiation therapy with intensity-modulated radiation technique for Stage T4 nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 65:1307–1314PubMed

Manavis J, Sivridis L, Koukourakis MI (2005) Nasopharyngeal carcinoma: the impact of CT-scan and of MRI on staging, radiotherapy treatment planning, and outcome of the disease. Clin Imaging 29:128–133PubMed

Chong VF, Fan YF (1997) Detection of recurrent nasopharyngeal carcinoma: MR imaging versus CT. Radiology 202:463–470PubMed

Ng SH, Chang JT, Ko SF, Wan YL, Tang LM, Chen WC (1999) MRI in recurrent nasopharyngeal carcinoma. Neuroradiology 41:855–862CrossRefPubMed

Ng SH, Liu HM, Ko SF, Hao SP, Chong VF (2002) Posttreatment imaging of the nasopharynx. Eur J Radiol 44:82–95CrossRefPubMed

10.

Ng SH, Wan YL, Ko SF, Chang JT (1998) MRI of nasopharyngeal carcinoma with emphasis on relationship to radiotherapy. J Magn Reson Imaging 8:327–336CrossRefPubMed

11.

Olmi P, Fallai C, Colagrande S, Giannardi G (1995) Staging and follow-up of nasopharyngeal carcinoma: magnetic resonance imaging versus computerized tomography. Int J Radiat Oncol Biol Phys 32:795–800PubMed

12.

Chan SC, Ng SH, Chang JT et al (2006) 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. Eur J Nucl Med Mol Imaging 33:1032–1040CrossRefPubMed

13.

Liu T, Xu W, Yan WL, Ye M, Bai YR, Huang G (2007) FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol 85:327–335CrossRefPubMed

14.

Yen RF, Hung RL, Pan MH et al (2003) 18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging. Cancer 98:283–287CrossRefPubMed

15.

Chan SC, Yen TC, Ng SH et al (2006) Differential roles of 18F-FDG PET in patients with locoregional advanced nasopharyngeal carcinoma after primary curative therapy: response evaluation and impact on management. J Nucl Med 47:1447–1454PubMed

16.

Yen RF, Hong RL, Tzen KY, Pan MH, Chen TH (2005) Whole-body 18F-FDG PET in recurrent or metastatic nasopharyngeal carcinoma. J Nucl Med 46:770–774PubMed

17.

Ng SH, Joseph CT, Chan SC et al (2004) Clinical usefulness of 18F-FDG PET in nasopharyngeal carcinoma patients with questionable MRI findings for recurrence. J Nucl Med 45:1669–1676PubMed

18.

Comoretto M, Balestreri L, Borsatti E, Cimitan M, Franchin G, Lise M (2008) Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy: comparison of MR imaging and FDG PET/CT. Radiology 249:203–211CrossRefPubMed

19.

Wang GH, Lau EW, Shakher R et al (2007) Clinical application of (18)F-FDG PET/CT to staging and treatment effectiveness monitoring of nasopharyngeal carcinoma. Ai Zheng 26:638–642PubMed

20.

Yu DF, Zuo CT, Dai JZ et al (2004) Application of 18F-FDG PET/CT scan in following-up of nasopharyngeal carcinoma after radiotherapy. Ai Zheng 23:1538–1541PubMed

21.

Walker RE, Eustace SJ (2001) Whole-body magnetic resonance imaging: techniques, clinical indications, and future applications. Semin Musculoskelet Radiol 5:5–20CrossRefPubMed

22.

Schick F (2005) Whole-body MRI at high field: technical limits and clinical potential. Eur Radiol 15:946–959CrossRefPubMed

23.

Lauenstein TC, Goehde SC, Herborn CU et al (2004) Whole-body MR imaging: evaluation of patients for metastases. Radiology 233:139–148CrossRefPubMed

24.

Schmidt GP, Wintersperger B, Graser A, Baur-Melnyk A, Reiser MF, Schoenberg SO (2007) High-resolution whole-body magnetic resonance imaging applications at 1.5 and 3 Tesla: a comparative study. Invest Radiol 42:449–459CrossRefPubMed

25.

Willinek WA, Schild HH (2008) Clinical advantages of 3.0 T MRI over 1.5 T. Eur J Radiol 65:2–14CrossRefPubMed

26.

Schmidt GP, Baur-Melnyk A, Haug A et al (2009) Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer. Eur Radiol 19:1366–1378CrossRefPubMed

27.

Schmidt GP, Baur-Melnyk A, Haug A et al (2008) Comprehensive imaging of tumor recurrence in breast cancer patients using whole-body MRI at 1.5 and 3 T compared to FDG-PET-CT. Eur J Radiol 65:47–58CrossRefPubMed

28.

van den Brekel MW, Stel HV, Castelijns JA et al (1990) Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 177:379–384PubMed

29.

Ng SH, Chang JT, Chan SC et al (2004) Nodal metastases of nasopharyngeal carcinoma: patterns of disease on MRI and FDG PET. Eur J Nucl Med Mol Imaging 31:1073–1080CrossRefPubMed

30.

Lam WW, Chan YL, Leung SF, Metreweli C (1997) Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Head Neck 19:176–181CrossRefPubMed

31.

Ng SH, Ko SF, Toh CH, Chen YL (2006) Imaging of neck metastases. Chang Gung Med J 29:119–129PubMed

32.

Metz CE (1986) ROC methodology in radiologic imaging. Invest Radiol 21:720–733CrossRefPubMed

33.

Hanley JA, McNeil BJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 148:839–843PubMed

34.

Sham JS, Wei WI, Kwan WH, Chan CW, Kwong WK, Choy D (1990) Nasopharyngeal carcinoma. Pattern of tumor regression after radiotherapy. Cancer 65:216–220CrossRefPubMed

35.

Fujii M, Kanzaki J (1994) The role of MRI for the diagnosis of recurrence of nasopharyngeal cancer. Auris Nasus Larynx 21:32–37PubMed

36.

Gong QY, Zheng GL, Zhu HY (1991) MRI differentiation of recurrent nasopharyngeal carcinoma from postradiation fibrosis. Comput Med Imaging Graph 15:423–429CrossRefPubMed

37.

Pfannenberg C, Aschoff P, Schanz S et al (2007) Prospective comparison of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and whole-body magnetic resonance imaging in staging of advanced malignant melanoma. Eur J Cancer 43:557–564CrossRefPubMed

38.

Antoch G, Vogt FM, Freudenberg LS et al (2003) Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA 290:3199–3206CrossRefPubMed

39.

Yi CA, Shin KM, Lee KS et al (2008) Non-small cell lung cancer staging: efficacy comparison of integrated PET/CT versus 3.0-T whole-body MR imaging. Radiology 248:632–642CrossRefPubMed

40.

Lauenstein TC, Goehde SC, Herborn CU et al (2002) Three-dimensional volumetric interpolated breath-hold MR imaging for whole-body tumor staging in less than 15 minutes: a feasibility study. AJR Am J Roentgenol 179:445–449PubMed

41.

Vogt FM, Herborn CU, Hunold P et al (2004) HASTE MRI versus chest radiography in the detection of pulmonary nodules: comparison with MDCT. AJR Am J Roentgenol 183:71–78PubMed

42.

Frericks BB, Meyer BC, Martus P, Wendt M, Wolf KJ, Wacker F (2008) MRI of the thorax during whole-body MRI: evaluation of different MR sequences and comparison to thoracic multidetector computed tomography (MDCT). J Magn Reson Imaging 27:538–545CrossRefPubMed

43.

Schmidt GP, Haug AR, Schoenberg SO, Reiser MF (2006) Whole-body MRI and PET-CT in the management of cancer patients. Eur Radiol 16:1216–1225CrossRefPubMed

44.

Ngan RK, Yiu HH, Cheng HK, Chan JK, Sin VC, Lau WH (2002) Central nervous system metastasis from nasopharyngeal carcinoma: a report of two patients and a review of the literature. Cancer 94:398–405CrossRefPubMed

45.

Gollub MJ, Hong R, Sarasohn DM, Akhurst T (2007) Limitations of CT during PET/CT. J Nucl Med 48:1583–1591CrossRefPubMed

46.

Yoshida K, Suzuki A, Nagashima T et al (2009) Staging primary head and neck cancers with (18)F-FDG PET/CT: is intravenous contrast administration really necessary? Eur J Nucl Med Mol Imaging 36:1417–1424CrossRefPubMed

Title: Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT
Authors: Shu-Hang Ng
Sheng-Chieh Chan
Tzu-Chen Yen
Chun-Ta Liao
Joseph Tung-Chieh Chang
Sheung-Fat Ko
Hung-Ming Wang
Chin-Yu Lin
Kai-Ping Chang
Yu-Chun Lin
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 9/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1784-9

At a glance: The STEP trials

Springer Medicine

Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2010

Multi-detector CT urography: effect of oral hydration and contrast medium volume on renal parenchymal enhancement and urinary tract opacification—a quantitative and qualitative analysis

Estimation of tissue perfusion by dynamic contrast-enhanced imaging: simulation-based evaluation of the steepest slope method

Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note

Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

In vivo assessment of experimental neonatal excitotoxic brain lesion with USPIO-enhanced MR imaging

Detection of relevant colonic neoplasms with PET/CT: promising accuracy with minimal CT dose and a standardised PET cut-off