Skip to main content

Advertisement

SpringerLink
Log in

PET/MRI and PET/CT in follow-up of head and neck cancer patients

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Positron emission tomography (PET)/MRI combines the functional ability of PET and the high soft tissue contrast of MRI. The aim of this study was to assess contrast-enhanced (ce)PET/MRI compared to cePET/CT in patients with suspected recurrence of head and neck cancer (HNC).

Methods

Eighty-seven patients underwent sequential cePET/CT and cePET/MRI using a trimodality PET/CT-MRI set-up. Diagnostic accuracy for the detection of recurrent HNC was evaluated using cePET/CT and cePET/MRI. Furthermore, image quality, presence of unclear 18F-fluorodeoxy-D-glucose (FDG) findings of uncertain significance and the diagnostic advantages of use of gadolinium contrast enhancement were analysed.

Results

cePET/MRI showed no statistically significant difference in diagnostic accuracy compared to cePET/CT (91.5 vs 90.6 %). Artefacts’ grade was similar in both methods, but their location was different. cePET/CT artefacts were primarily located in the suprahyoid area, while on cePET/MRI, artefacts were more equally distributed among the supra and infrahyoid neck regions. cePET/MRI and cePET/CT showed 34 unclear FDG findings; of those 11 could be solved by cePET/MRI and 5 by cePET/CT. The use of gadolinium in PET/MRI did not yield higher diagnostic accuracy, but helped to better define tumour margins in 6.9 % of patients.

Conclusion

Our data suggest that cePET/MRI may be superior compared to cePET/CT to specify unclear FDG uptake related to possible tumour recurrence in follow-up of patients after HNC. It seems to be the modality of choice for the evaluation of the oropharynx and the oral cavity because of a higher incidence of artefacts in cePET/CT in this area mainly due to dental implants. However, overall there is no statistically significant difference.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rangaswamy B, Fardanesh MR, Genden EM, Park EE, Fatterpekar G, Patel Z, et al. Improvement in the detection of locoregional recurrence in head and neck malignancies: F-18 fluorodeoxyglucose-positron emission tomography/computed tomography compared to high-resolution contrast-enhanced computed tomography and endoscopic examination. Laryngoscope 2013;123:2664–9.

    Google Scholar 

  2. Sadick M, Schoenberg SO, Hoermann K, Sadick H. Current oncologic concepts and emerging techniques for imaging of head and neck squamous cell cancer. GMS Curr Top Otorhinolaryngol Head Neck Surg 2012;11:Doc08.

    PubMed Central  PubMed  Google Scholar 

  3. Herrmann K, Krause BJ, Bundschuh RA, Dechow T, Schwaiger M. Monitoring response to therapeutic interventions in patients with cancer. Semin Nucl Med 2009;39(3):210–32.

    Article  PubMed  Google Scholar 

  4. Abgral R, Querellou S, Potard G, Le Roux PY, Le Duc-Pennec A, Marianovski R, et al. Does 18F-FDG PET/CT improve the detection of posttreatment recurrence of head and neck squamous cell carcinoma in patients negative for disease on clinical follow-up? J Nucl Med 2009;50(1):24–9.

    Article  PubMed  Google Scholar 

  5. Ul-Hassan F, Simo R, Guerrero-Urbano T, Oakley R, Jeannon JP, Cook GJ. Can (18)F-FDG PET/CT reliably assess response to primary treatment of head and neck cancer? Clin Nucl Med 2013;38(4):263–5.

    Article  PubMed  Google Scholar 

  6. Schöder H, Fury M, Lee N, Kraus D. PET monitoring of therapy response in head and neck squamous cell carcinoma. J Nucl Med 2009;50 Suppl 1:74S–88S.

    Article  PubMed  Google Scholar 

  7. Saito N, Nadgir RN, Nakahira M, Takahashi M, Uchino A, Kimura F, et al. Posttreatment CT and MR imaging in head and neck cancer: what the radiologist needs to know. Radiographics 2012;32:1261–82.

    Article  PubMed  Google Scholar 

  8. Castaldi P, Leccisotti L, Bussu F, Miccichè F, Rufini V. Role of (18)F-FDG PET-CT in head and neck squamous cell carcinoma. Acta Otorhinolaryngol Ital 2013;33(1):1–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  9. Offiah C, Hall E. Post-treatment imaging appearances in head and neck cancer patients. Clin Radiol 2011;66(1):13–24.

    Article  CAS  PubMed  Google Scholar 

  10. Platzek I, Beuthien-Baumann B, Schneider M, Gudziol V, Langner J, Schramm G, et al. PET/MRI in head and neck cancer: initial experience. Eur J Nucl Med Mol Imaging 2013;40(1):6–11.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Chawla S, Kim S, Dougherty L, Wang S, Loevner LA, Quon H, et al. Pretreatment diffusion-weighted and dynamic contrast-enhanced MRI for prediction of local treatment response in squamous cell carcinomas of the head and neck. AJR Am J Roentgenol 2013;200(1):35–43.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Kuhn F, Huellner M, von Schulthess G, Veit-Haibach P. Comparison of contrast enhanced PET/MRI and contrast enhanced PET/CT in patients with head and neck cancer. J Nucl Med 2013;54(Suppl 2):515.

    Google Scholar 

  13. Veit-Haibach P, Kuhn FP, Wiesinger F, Delso G, von Schulthess G. PET-MR imaging using a tri-modality PET/CT-MR system with a dedicated shuttle in clinical routine. MAGMA 2013;26:25–35.

    Google Scholar 

  14. Kuhn FP, Crook DW, Mader CE, Appenzeller P, von Schulthess GK, Schmid DT. Discrimination and anatomical mapping of PET-positive lesions: comparison of CT attenuation-corrected PET images with coregistered MR and CT images in the abdomen. Eur J Nucl Med Mol Imaging 2013;40(1):44–51.

    Article  PubMed  Google Scholar 

  15. Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging 2010;37(1):181–200.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Kuhn F, Wiesinger F, Wollenweber S, Samarin A, Von Schulthess G, Schmid D. Sequential integrated PET/CT-MR system: comparison of image registration accuracy of PET/CT versus PET/MR. Melbourne, Australia: International Society for Magnetic Resonance in Medicine (ISMRM); 2012

  17. Glastonbury CM, Salzman KL. Pitfalls in the staging of cancer of nasopharyngeal carcinoma. Neuroimaging Clin N Am 2013;23(1):9–25.

    Article  PubMed  Google Scholar 

  18. Buchbender C, Heusner TA, Lauenstein TC, Bockisch A, Antoch G. Oncologic PET/MRI, part 1: tumors of the brain, head and neck, chest, abdomen, and pelvis. J Nucl Med 2012;53(6):928–38.

    Article  PubMed  Google Scholar 

  19. von Schulthess GK, Kuhn FP, Kaufmann P, Veit-Haibach P. Clinical positron emission tomography/magnetic resonance imaging applications. Semin Nucl Med 2013;43(1):3–10.

    Article  Google Scholar 

  20. Appenzeller P, Mader C, Huellner MW, Schmidt D, Schmid D, Boss A, et al. PET/CT versus body coil PET/MRI: how low can you go? Insights Imaging 2013;4(4):481–90.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Castelijns JA. PET-MRI in the head and neck area: challenges and new directions. Eur Radiol 2011;21(11):2425–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Bhargava P, Rahman S, Wendt J. Atlas of confounding factors in head and neck PET/CT imaging. Clin Nucl Med 2011;36(5):e20–9.

    Article  PubMed  Google Scholar 

  23. Nagamachi S, Nishii R, Wakamatsu H, Mizutani Y, Kiyohara S, Fujita S, et al. The usefulness of (18)F-FDG PET/MRI fusion image in diagnosing pancreatic tumor: comparison with (18)F-FDG PET/CT. Ann Nucl Med 2013;27(6):554–63.

    Article  PubMed  Google Scholar 

  24. Kitajima K, Suenaga Y, Ueno Y, Kanda T, Maeda T, Takahashi S, et al. Value of fusion of PET and MRI for staging of endometrial cancer: comparison with (18)F-FDG contrast-enhanced PET/CT and dynamic contrast-enhanced pelvic MRI. Eur J Radiol 2013;82(10):1672–6.

    Article  PubMed  Google Scholar 

  25. Pfluger T, Melzer HI, Mueller WP, Coppenrath E, Bartenstein P, Albert MH, et al. Diagnostic value of combined (18)F-FDG PET/MRI for staging and restaging in paediatric oncology. Eur J Nucl Med Mol Imaging 2012;39(11):1745–55.

    Article  PubMed  Google Scholar 

  26. Nakamoto Y, Tamai K, Saga T, Higashi T, Hara T, Suga T, et al. Clinical value of image fusion from MR and PET in patients with head and neck cancer. Mol Imaging Biol 2009;11(1):46–53.

    Article  PubMed  Google Scholar 

  27. Ishikita T, Oriuchi N, Higuchi T, Miyashita G, Arisaka Y, Paudyal B, et al. Additional value of integrated PET/CT over PET alone in the initial staging and follow up of head and neck malignancy. Ann Nucl Med 2010;24(2):77–82.

    Article  PubMed  Google Scholar 

  28. Passero VA, Branstetter BF, Shuai Y, Heron DE, Gibson MK, Lai SY, et al. Response assessment by combined PET-CT scan versus CT scan alone using RECIST in patients with locally advanced head and neck cancer treated with chemoradiotherapy. Ann Oncol 2010;21(11):2278–83.

    Article  CAS  PubMed  Google Scholar 

  29. Kim SY, Kim JS, Yi JS, Lee JH, Choi SH, Nam SY, et al. Evaluation of 18F-FDG PET/CT and CT/MRI with histopathologic correlation in patients undergoing salvage surgery for head and neck squamous cell carcinoma. Ann Surg Oncol 2011;18(9):2579–84.

    Article  PubMed  Google Scholar 

  30. Samarin A, Burger C, Wollenweber SD, Crook DW, Burger IA, Schmid DT, et al. PET/MR imaging of bone lesions–implications for PET quantification from imperfect attenuation correction. Eur J Nucl Med Mol Imaging 2012;39(7):1154–60.

    Article  PubMed  Google Scholar 

  31. Nassenstein K, Veit-Haibach P, Stergar H, Gutzeit A, Freudenberg L, Kuehl H, et al. Cervical lymph node metastases of unknown origin: primary tumor detection with whole-body positron emission tomography/computed tomography. Acta Radiol 2007;48(10):1101–8.

    Article  CAS  PubMed  Google Scholar 

  32. Barral JK, Santos JM, Damrose EJ, Fischbein NJ, Nishimura DG. Real-time motion correction for high-resolution larynx imaging. Magn Reson Med 2011;66(1):174–9.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Prestwich RJ, Sykes J, Carey B, Sen M, Dyker KE, Scarsbrook AF. Improving target definition for head and neck radiotherapy: a place for magnetic resonance imaging and 18-fluoride fluorodeoxyglucose positron emission tomography? Clin Oncol (R Coll Radiol) 2012;24(8):577–89.

    Article  CAS  Google Scholar 

Download references

Disclosures

This research project was supported by an institutional research grant from GE Healthcare. Patrick Veit-Haibach received IIS Grants from Bayer Healthcare and Siemens Medical Solutions and speaker fees from GE Healthcare. Gustav von Schulthess is a grant recipient from GE Healthcare and receives speaker fees from GE Healthcare.

Conflicts of interest

The other authors declare no other conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Medical Radiology, Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland

    Marcelo A. Queiroz, Martin Hüllner, Felix Kuhn, Gustav von Schulthess & Patrick Veit-Haibach

  2. Department of Medical Radiology, Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland

    Felix Kuhn & Patrick Veit-Haibach

  3. Department of Medical Radiology, Neuroradiology, University Hospital Zurich, Zurich, Switzerland

    Martin Hüllner & Spyros Kollias

  4. Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland

    Gerhardt Huber & Christian Meerwein

  5. Department of Nuclear Medicine, University Hospital Zurich, 8091, Zurich, Switzerland

    Marcelo A. Queiroz

Authors
  1. Marcelo A. Queiroz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Hüllner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Felix Kuhn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gerhardt Huber
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Meerwein
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Spyros Kollias
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gustav von Schulthess
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Patrick Veit-Haibach
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcelo A. Queiroz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Queiroz, M.A., Hüllner, M., Kuhn, F. et al. PET/MRI and PET/CT in follow-up of head and neck cancer patients. Eur J Nucl Med Mol Imaging 41, 1066–1075 (2014). https://doi.org/10.1007/s00259-014-2707-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-014-2707-9

Keywords

Search

Navigation