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Comparison of 18F-FDG PET/MRI, MRI, and 18F-FDG PET/CT for the detection of synchronous cancers and distant metastases in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma

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Abstract

Purpose

In this prospective study, we sought to compare the clinical utility of fluorodeoxyglucose PET/MRI, MRI, and PET/CT in the detection of synchronous cancers and distant metastases in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma (OHSCC).

Methods

We examined 198 consecutive patients with biopsy-proven OHSCC who agreed to receive chemoradiation. All patients underwent pretreatment PET/MRI and PET/CT on the same day. Patients were followed-up for a minimum of 12 months or until death. The McNemar’s test and receiver-operating characteristic (ROC) curves were used to compare sensitivity/specificity and the diagnostic capabilities of PET/MRI, MRI, and PET/CT, respectively.

Results

We identified 55 patients (27.7%) who had synchronous cancers and/or distant metastases (number of involved sites: 83). The results of site-based analysis revealed that the sensitivity of PET/MRI was 15.7% higher than that of MRI (73.5% versus 57.8%, p < 0.001) and 3.6% higher compared with PET/CT (73.5% versus 69.9%, p = 0.083), whereas the sensitivity of PET/CT was 12.1% higher than that of MRI (69.9% versus 57.8%, p = 0.012). On a patient-basis, ROC curve analysis demonstrated that PET/MRI yielded a greater area under curve than MRI (0.930 versus 0.905, p = 0.023). There were no significant differences in terms of diagnostic capability between MRI and PET/CT (0.905 versus 0.917, p = 0.469) and between PET/MRI and PET/CT (0.930 versus 0.917, p = 0.062).

Conclusions

In our cohort, PET/MRI showed a significantly higher diagnostic capability than MRI and no significant difference compared with PET/CT for the detection of synchronous cancers or distant metastases in patients with OHSCC.

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Funding

This study was supported by a grant (MOST 104-2314-B-182A -091 -MY3) from the Taiwan Ministry of Science and Technology.

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Author notes

  1. Chih-Hua Yeh and Sheng-Chieh Chan contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chih-Hua Yeh & Shu-Hang Ng

  2. Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

    Sheng-Chieh Chan

  3. Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chien-Yu Lin, Joseph Tung-Chieh Chang & Kang-Hsing Fan

  4. Molecular Imaging Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Tzu-Chen Yen & Shu-Hang Ng

  5. Department of Nuclear Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Tzu-Chen Yen

  6. Department of Medical Imaging and Intervention, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Sheung-Fat Ko

  7. Division of Medical Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Hung-Ming Wang

  8. Department of Otorhinolaryngology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chun-Ta Liao

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  1. Chih-Hua Yeh
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Correspondence to Shu-Hang Ng.

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This article is part of the Topical Collection on Oncology – Head and Neck

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Yeh, CH., Chan, SC., Lin, CY. et al. Comparison of 18F-FDG PET/MRI, MRI, and 18F-FDG PET/CT for the detection of synchronous cancers and distant metastases in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging 47, 94–104 (2020). https://doi.org/10.1007/s00259-019-04510-5

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