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Clinical utility of simultaneous whole-body 18F-FDG PET/MRI as a single-step imaging modality in the staging of primary nasopharyngeal carcinoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Both head and neck magnetic resonance imaging (MRI) and 18F–fluorodeoxyglucose (18F–FDG) positron emission tomography (PET)/computed tomography (CT) play a crucial role in the staging of primary nasopharyngeal carcinoma (NPC). In this study, we sought to prospectively investigate the clinical utility of simultaneous whole-body 18F–FDG PET/MRI for primary staging of NPC patients.

Methods

We examined 113 patients with histologically confirmed NPC who underwent pretreatment, simultaneous whole-body PET/MRI and PET/CT for primary tumor staging. The images obtained with the different imaging modalities were interpreted independently and compared with each other.

Results

PET/MRI increased the accuracy of head and neck MRI for assessment of primary tumor extent in four patients via addition of FDG uptake information to increase the conspicuity of morphologically subtle lesions. PET/MR images were more discernible than PET/CT images for mapping tumor extension, especially intracranial invasion. Regarding the N staging assessment, the sensitivity of PET/MRI (99.5%) was higher than that of head and neck MRI (94.2%) and PET/CT (90.9%). PET/MRI was particularly useful for distinguishing retropharyngeal nodal metastasis from adjacent nasopharyngeal tumors. For distant metastasis evaluation, PET/MRI exhibited a similar sensitivity (90% vs. 86.7% vs. 83.3%), but higher positive predictive value (93.1% vs. 78.8% vs. 83.3%) than whole-body MRI and PET/CT, respectively.

Conclusions

For tumor staging of NPC, simultaneous whole-body PET/MRI was more accurate than head and neck MRI and PET/CT, and may serve as a single-step staging modality.

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Funding

This study was funded by the Taiwan Ministry of Science and Technology (grant number NSC104–2314-B-182A-084 -MY3 and NSC 102–2314-B-182A-096) and the Chang Gung Memorial Hospital (grants CMRPG2E0191).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Linkou Chang Gung Memorial Hospital, Linkou, Taiwan

    Sheng-Chieh Chan & Tzu-Chen Yen

  2. Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chih-Hua Yeh & Shu-Hang Ng

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

    Joseph Tung-Chieh Chang, Chien-Yu Lin, Tsang Yen-Ming, Kang-Hsing Fan & Bing-Shen Huang

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

    Cheng-Lung Hsu & Hung-Ming Wang

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

    Kai-Ping Chang & Chun-Ta Liao

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  1. Sheng-Chieh Chan
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  2. Chih-Hua Yeh
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  10. Cheng-Lung Hsu
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  11. Kai-Ping Chang
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  13. Chun-Ta Liao
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Correspondence to Shu-Hang Ng.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Chan, SC., Yeh, CH., Yen, TC. et al. Clinical utility of simultaneous whole-body 18F-FDG PET/MRI as a single-step imaging modality in the staging of primary nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging 45, 1297–1308 (2018). https://doi.org/10.1007/s00259-018-3986-3

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  • DOI: https://doi.org/10.1007/s00259-018-3986-3

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