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

  • 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
Original Article

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.

Keywords

PET/CT MRI Nasopharyngeal carcinoma TNM staging 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Shu-Hang Ng
    • 1
    • 6
  • Sheng-Chieh Chan
    • 2
  • Tzu-Chen Yen
    • 2
  • Joseph Tung-Chieh Chang
    • 3
  • Chun-Ta Liao
    • 4
  • Sheung-Fat Ko
    • 1
  • Feng-Yuan Liu
    • 2
  • Shu-Chyn Chin
    • 1
  • Kang-Hsing Fan
    • 3
  • Cheng-Lung Hsu
    • 5
  1. 1.Molecular Imaging Center and Department of Diagnostic RadiologyChang Gung Memorial Hospital Linkou Medical CenterKueishanTaiwan
  2. 2.Department of Nuclear MedicineChang Gung Memorial Hospital Linkou Medical CenterKueishanTaiwan
  3. 3.Department of Radiation OncologyChang Gung Memorial Hospital Linkou Medical CenterKueishanTaiwan
  4. 4.Department of OtorhinolaryngologyChang Gung Memorial Hospital Linkou Medical CenterKueishanTaiwan
  5. 5.Department of Medical OncologyChang Gung Memorial Hospital Linkou Medical CenterKueishanTaiwan
  6. 6.Department of Diagnostic RadiologyChang Gung Memorial Hospital, Linkou Medical CenterKueishanTaiwan

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