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PET/CT for staging and follow-up of pediatric nasopharyngeal carcinoma

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

Abstract

Purpose

While FDG PET/CT for the evaluation of nasopharyngeal carcinoma (NPC) in adult patients has documented advantages and disadvantages compared with conventional imaging, to our knowledge, no studies of FDG PET/CT for the evaluation of NPC in pediatric patients have been performed. In this investigation, we studied the utility of FDG PET/CT in children with NPC.

Methods

The study group comprised 18 children with biopsy-proven NPC who underwent FDG PET/CT and MRI (total 38 pairs of images). All baseline and follow-up FDG PET/CT and MRI studies were independently reviewed for restaging of disease.

Results

The concordance between FDG PET/CT and MRI in T, N, and overall staging was 29%, 64%, and 43%, respectively. Compared with MRI, FDG PET/CT yielded lower T and overall staging and showed less cervical and retropharyngeal lymphadenopathy. The concordance between follow-up FDG PET/CT and MRI was 79% overall and 100% 9 months after therapy. In patients who achieved complete remission, FDG PET/CT showed disease clearance 3–6 months earlier than MRI. There were no false-positive or false-negative FDG PET/CT scans during follow-up.

Conclusion

FDG PET/CT may underestimate tumor extent and regional lymphadenopathy compared with MRI at the time of diagnosis, but it helps to detect metastases and clarify ambiguous findings. FDG PET/CT is sensitive and specific for follow-up and enables earlier determination of disease remission. FDG PET/CT is a valuable imaging modality for the evaluation and monitoring of NPC in pediatric patients.

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Acknowledgments

We thank Sandra Gaither for secretarial support and David Galloway for scientific editing. The work was supported by the American Lebanese Syrian Associated Charities.

Conflicts of interest

None.

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Author notes

  1. Daniel K. L. Cheuk

    Present address: Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pokfulam, Hong Kong

  2. Mihir Naik

    Present address: Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX, USA

  3. Carlos Rodriguez-Galindo

    Present address: Dana-Farber Cancer Institute, Hematology/Oncology, 44 Binney Street SW 350, Boston, MA, 2115, USA

Authors and Affiliations

  1. Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN, 38105-3678, USA

    Daniel K. L. Cheuk & Carlos Rodriguez-Galindo

  2. Department of Radiological Sciences, St Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA

    Noah D. Sabin, Moinul Hossain, Mihir Naik, Matthew J. Krasin & Barry L. Shulkin

  3. Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, TN, 38105-3678, USA

    Amy Wozniak

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Correspondence to Barry L. Shulkin.

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Cheuk, D.K.L., Sabin, N.D., Hossain, M. et al. PET/CT for staging and follow-up of pediatric nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging 39, 1097–1106 (2012). https://doi.org/10.1007/s00259-012-2091-2

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  • DOI: https://doi.org/10.1007/s00259-012-2091-2

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