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Advantages and pitfalls of 18F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma: comparison with magnetic resonance imaging

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Abstract

Introduction

This prospective study was designed to elucidate the advantages and pitfalls of 18F-FDG PET in detecting locally residual/recurrent nasopharyngeal carcinoma (NPC) in comparison with MRI.

Methods

We recruited NPC patients from two ongoing prospective trials. One is being performed to evaluate suspected local recurrence (group A) and the other to assess local treatment response 3 months after therapy (group B). Both groups received 18F-FDG PET and head and neck MRI. The gold standard was histopathology or clinical/imaging follow-up. An optimal cut-off standardised uptake value (SUV) was retrospectively determined.

Results

From January 2002 to August 2004, 146 patients were eligible. Thirty-four were from group A and 112 from group B. In all, 26 had locally recurrent/residual tumours. Differences in detection rate between 18F-FDG PET and MRI were not statistically significant in either group. However, 18F-FDG PET showed significantly higher specificity than MRI in detecting residual tumours among patients with initial T4 disease (p=0.04). In contrast, the specificity of 18F-FDG PET for patients with an initial T1–2 tumour treated with intracavitary brachytherapy (ICBT) was significantly lower than that for patients not treated by ICBT (72.2% vs 98.1%, p=0.003). At an SUV cut-off of 4.2, PET showed an equal and a higher accuracy compared with MRI in groups A and B, respectively.

Conclusion

18F-FDG PET is superior to MRI in identifying locally residual NPC among patients with initial T4 disease but demonstrates limitations in assessing treatment response in patients with initial T1–2 disease after ICBT. A cut-off SUV is a useful index for aiding in the visual detection of locally residual/recurrent NPC.

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Acknowledgement

This work was supported by grants CMRPG-32034 and CMRPG-32039 from Chang Gung Memorial Hospital.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Chang Gung Memorial Hospital Linkou Medical Center, 5 Fu-Shin St, Kueishan, Taoyuan, Taiwan, 333, Republic of China

    Sheng-Chieh Chan, Yu-Chen Chang & Tzu-Chen Yen

  2. Department of Diagnostic Radiology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan, Republic of China

    Shu-Hang Ng

  3. Department of Radiation Oncology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan, Republic of China

    Joseph Tung-Chieh Chang, Chien-Yu Lin & Yen-Chao Chen

  4. Department of Haematology/Oncology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan, Republic of China

    Cheng-Lung Hsu & Hung-Ming Wang

  5. Department of Otorhinolaryngology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan, Republic of China

    Chun-Ta Liao

  6. Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan, Republic of China

    Sheng-Chieh Chan, Shu-Hang Ng, Joseph Tung-Chieh Chang, Chien-Yu Lin, Yen-Chao Chen, Yu-Chen Chang, Cheng-Lung Hsu, Hung-Ming Wang, Chun-Ta Liao & Tzu-Chen Yen

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  1. Sheng-Chieh Chan
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  2. Shu-Hang Ng
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  10. Tzu-Chen Yen
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Correspondence to Tzu-Chen Yen.

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Chan, SC., Ng, SH., Chang, J.TC. et al. Advantages and pitfalls of 18F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma: comparison with magnetic resonance imaging. Eur J Nucl Med Mol Imaging 33, 1032–1040 (2006). https://doi.org/10.1007/s00259-005-0054-6

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  • DOI: https://doi.org/10.1007/s00259-005-0054-6

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