Top

Published in:

01-12-2009 | Head and Neck

Pretreatment evaluation of distant-site status in patients with nasopharyngeal carcinoma: accuracy of whole-body MRI at 3-Tesla and FDG-PET-CT

Authors: Shu-Hang Ng, Sheng-Chieh Chan, Tzu-Chen Yen, Joseph Tung-Chieh Chang, Chun-Ta Liao, Sheung-Fat Ko, Hung-Ming Wang, Yau-Yau Wai, Jiun-Jie Wang, Min-Chi Chen

Published in: European Radiology | Issue 12/2009

Abstract

We sought to prospectively evaluate the accuracy of 3.0-Tesla 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 assessment of distant-site status in 150 patients with untreated nasopharyngeal carcinoma (NPC). Eighteen (12%) patients were diagnosed as having distant malignancies (15 patients had distant metastases, and three distant synchronous tumours). On a patient-based analysis, WB-MRI and FDG-PET-CT showed similar sensitivity (77.8% vs 72.2%, P > 0.999), specificity (98.5% vs 97.7%, P > 0.999) and diagnostic capability (0.905 vs 0.878, P = 0.669). Combined interpretation of WB-MRI and FDG-PET-CT showed no significant benefit over either technique alone. In conclusion, 3.0-Tesla WB-MRI is a feasible, non-ionising technique that showed similar diagnostic capacity to FDG-PET-CT in assessing distant-site status in patients with untreated NPC and can be recommended as the first-line imaging technique for comprehensive evaluation of such patients.

Fandi A, Altrun M, Azli N et al (1994) Nasopharyngeal cancer: epidemiology, staging, and treatment. Semin Oncol 21:382–397PubMed

Wei WI, Sham JST (2005) Nasopharyngeal carcinoma. Lancet 365:2041–2054CrossRefPubMed

Ng SH, Chang TC, Ko SF et al (1997) Nasopharyngeal carcinoma: MRI and CT assessment. Neuroradiology 39:741–746CrossRefPubMed

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

Sakata K, Hareyama M, Tamakawa M et al (1999) Prognostic factors of nasopharynx tumors investigated by MR imaging and the value of MR imaging in the newly published TNM staging. Int J Radiat Oncol Biol Phys 43:273–278PubMed

Chang JT, Lin CY, Chen TM et al (2005) Nasopharyngeal carcinoma with cranial nerve palsy: the importance of MRI for radiotherapy. Int J Radiat Oncol Biol Phys 63:1354–1360CrossRefPubMed

Lee AW, Sze WM, Au JS, Leung SF et al (2005) Treatment results for nasopharyngeal carcinoma in the modern era: the Hong Kong experience. Int J Radiat Oncol Biol Phys 61:1107–1116PubMed

Liao XB, Mao YP, Liu LZ et al (2008) How does magnetic resonance imaging influence staging according to AJCC staging system for nasopharyngeal carcinoma compared with computed tomography? Int J Radiat Oncol Biol Phys 72:1368–1377PubMed

Kumar MB, Lu JJ, Loh KS et al (2004) Tailoring distant metastatic imaging for patients with clinically localized undifferentiated nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 58:688–693PubMed

10.

Chang JT, Chan SC, Yen TC et al (2005) Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography. Int J Radiat Oncol Biol Phys 62:501–507PubMed

11.

Yen TC, Chang JT, Ng SH et al (2005) The value of 18F-FDG PET in the detection of stage M0 carcinoma of the nasopharynx. J Nucl Med 46:405–10PubMed

12.

Ng SH, Chan SC, Yen TC et al (2009) Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up. Eur J Nucl Med Mol Imaging 36:12–22CrossRefPubMed

13.

King AD, Ma BB, Yau YY, Zee B et al (2008) The impact of 18F-FDG PET/CT on assessment of nasopharyngeal carcinoma at diagnosis. Br J Radiol 81:291–298CrossRefPubMed

14.

Gordin A, Golz A, Daitzchman M et al (2007) Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in patients with carcinoma of the nasopharynx: diagnostic accuracy and impact on clinical management. Int J Radiat Oncol Biol Phys 68:370–376PubMed

15.

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

16.

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

17.

Lauenstein TC, Goehde SC, Herborn CU et al (2008) Whole-body MR imaging: evaluation of patients for metastases. Radiology 233:139–148CrossRef

18.

Lo GG, Ai V, Au-Yeung KM, Chan JK, Li KW, Chien D (2008) Magnetic resonance whole body imaging at 3 Tesla: feasibility and findings in a cohort of asymptomatic medical doctors. Hong Kong Med J 14:90–96PubMed

19.

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

20.

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

21.

Kuhl CK, Traber F, Schild HH (2008) Whole-body high-field-strength (3.0-T) MR Imaging in Clinical Practice. Part I. Technical considerations and clinical applications. Radiology 246:675–696CrossRefPubMed

22.

Ohno Y, Koyama H, Nogami M et al (2007) Whole-body MR imaging vs. FDG-PET: comparison of accuracy of M-stage diagnosis for lung cancer patients. J Magn Reson Imaging 26:498–509CrossRefPubMed

23.

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 290:3199–206CrossRefPubMed

24.

Herborn CU, Unkel C, Vogt FM, Massing S, Lauenstein TC, Neumann A (2005) Whole–body MRI for staging patients with head and neck squamous cell carcinoma. Acta Otolaryngol 125:1224–1229CrossRefPubMed

25.

Lauenstein TC, Semelka RC (2006) Emerging techniques: whole-body screening and staging with MRI. J Magn Reson Imaging 24:489–98CrossRefPubMed

26.

Schmidt GP, Haug AR, Schoenberg SO, Reiser MF (2006) Whole-body MRI and PET-CT in the management of cancer patients. Eur Radiol 16:1216–25CrossRefPubMed

27.

Johnston C, Brennan S, Ford S, Eustace S (2006) Whole body MR imaging: applications in oncology. Eur J Surg Oncol 32:239–246CrossRefPubMed

28.

Brennan DD, Gleeson T, Coate LE, Cronin C, Carney D, Eustace SJ (2005) A comparison of whole-body MRI and CT for the staging of lymphoma. AJR Am J Roentgenol 185:711–716CrossRefPubMed

29.

Daldrup-Link HE, Franzius C et al (2001) Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG PET. AJR Am J Roentgenol 177:229–236PubMed

30.

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

31.

Ohno Y, Koyama H, Onishi Y, Takenaka D et al (2008) Non-small cell lung cancer: whole-body MR examination for M-stage assessment—utility for whole-body diffusion-weighted Imaging compared with integrated FDG PET/CT. Radiology 248:643–654CrossRefPubMed

32.

Baur-Melnyk A, Buhmann S, Becker C et al (2008) Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. AJR Am J Roentgenol 190:1097–1104CrossRefPubMed

33.

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

34.

Lin C, Luciani A, Itti E, Haioun C, Rahmouni A (2007) Whole body MRI and PET/CT in haematological malignancies. Cancer Imaging 7:S88–S93CrossRefPubMed

35.

Squillaci E, Manenti G, Mancino S et al (2008) Staging of colon cancer: whole-body MRI vs. whole-body PET-CT-initial clinical experience. Abdom Imaging 33:676–688CrossRefPubMed

36.

Liu FY, Chang JT, Wang HM et al (2006) [18F]fluorodeoxyglucose positron emission tomography is more sensitive than skeletal scintigraphy for detecting bone metastasis in endemic nasopharyngeal carcinoma at initial staging. J Clin Oncol 24:599–604CrossRefPubMed

37.

Brouwer J, de Bree R, Hoekstra OS et al (2005) Screening for distant metastases in patients with head and neck cancer: is chest computed tomography sufficient? Laryngoscope 115:1813–1817CrossRefPubMed

38.

Leemans CR, Tiwari R, Nauta JJ, van der Waal I, Snow GB (1993) Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer 71:452–456CrossRefPubMed

39.

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

40.

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

41.

Schmidt GP, Baur-Melnyk A, Herzog P et al (2005) High-resolution whole-body magnetic resonance image tumor staging with the use of parallel imaging versus dual-modality positron emission tomography-computed tomography: experience on a 32-channel system. Invest Radiol 40:743–753CrossRefPubMed

42.

Schmidt GP, Schoenberg SO, Reiser MF, Baur-Melnyk A (2005) Whole-body MR imaging of bone marrow. Eur J Radiol 55:33–40CrossRefPubMed

43.

Schmidt GP, Schoenberg SO, Schmid R et al (2007) Screening for bone metastases: whole-body MRI using a 32-channel system versus dual-modality PET-CT. Eur Radiol 17:939–949CrossRefPubMed

44.

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

45.

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

46.

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

Title: Pretreatment evaluation of distant-site status in patients with nasopharyngeal carcinoma: accuracy of whole-body MRI at 3-Tesla and FDG-PET-CT
Authors: Shu-Hang Ng
Sheng-Chieh Chan
Tzu-Chen Yen
Joseph Tung-Chieh Chang
Chun-Ta Liao
Sheung-Fat Ko
Hung-Ming Wang
Yau-Yau Wai
Jiun-Jie Wang
Min-Chi Chen
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 12/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1504-5

At a glance: The STEP trials

Springer Medicine

Pretreatment evaluation of distant-site status in patients with nasopharyngeal carcinoma: accuracy of whole-body MRI at 3-Tesla and FDG-PET-CT

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2009

Differentiating high-grade from low-grade chondrosarcoma with MR imaging

Effective dose evaluation of multidetector CT examinations: influence of the ICRP recommendation in 2007

Detection of pulmonary embolism by dual energy CT: correlation with perfusion scintigraphy and histopathological findings in rabbits

Letter to the Editor: re: Body physique and heart rate variability determine the occurrence of stair-step artefacts in 64-slice CT coronary angiography with prospective ECG-triggering

Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures

Grading of carotid artery stenosis with multidetector-row CT angiography: visual estimation or caliper measurements?