Assessment of metastatic lymph nodes in head and neck squamous cell carcinomas using simultaneous 18F-FDG-PET and MRI

Autor: Mari Hagiwara, Artem Mikheev, Henry Rusinek, Brian L. Schmidt, Cheng Liu, Qi Chen, Jean Logan, Jenny Chen, Sungheon Kim, Babak Givi
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Article
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Text mining
Image processing
Fluorodeoxyglucose F18
Humans
Medicine
Head and neck cancer
Lymph node
Aged
Aged
80 and over

Multidisciplinary
Clinical pathology
medicine.diagnostic_test
Squamous Cell Carcinoma of Head and Neck
business.industry
Diagnostic markers
Magnetic resonance imaging
Middle Aged
Prognosis
medicine.disease
Magnetic Resonance Imaging
Head and neck squamous-cell carcinoma
medicine.anatomical_structure
Head and Neck Neoplasms
Positron emission tomography
Lymphatic Metastasis
Positron-Emission Tomography
030220 oncology & carcinogenesis
Female
Lymph Nodes
Lymph
Radiopharmaceuticals
business
Nuclear medicine
Follow-Up Studies
Diffusion MRI
Zdroj: Scientific Reports
ISSN: 2045-2322
Popis: In this study, we investigate the feasibility of using dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), diffusion weighted imaging (DWI), and dynamic positron emission tomography (PET) for detection of metastatic lymph nodes in head and neck squamous cell carcinoma (HNSCC) cases. Twenty HNSCC patients scheduled for lymph node dissection underwent DCE-MRI, dynamic PET, and DWI using a PET-MR scanner within one week prior to their planned surgery. During surgery, resected nodes were labeled to identify their nodal levels and sent for routine clinical pathology evaluation. Quantitative parameters of metastatic and normal nodes were calculated from DCE-MRI (ve, vp, PS, Fp, Ktrans), DWI (ADC) and PET (Ki, K1, k2, k3) to assess if an individual or a combination of parameters can classify normal and metastatic lymph nodes accurately. There were 38 normal and 11 metastatic nodes covered by all three imaging methods and confirmed by pathology. 34% of all normal nodes had volumes greater than or equal to the smallest metastatic node while 4 normal nodes had SUV > 4.5. Among the MRI parameters, the median vp, Fp, PS, and Ktrans values of the metastatic lymph nodes were significantly lower (p = e and ADC did not show any statistical significance. For the dynamic PET parameters, the metastatic nodes had significantly higher k3 (p value = 8.8 × 10−8) and Ki (p value = 5.3 × 10−8) than normal nodes. K1 and k2 did not show any statistically significant difference. Ki had the best separation with accuracy = 0.96 (sensitivity = 1, specificity = 0.95) using a cutoff of Ki = 5.3 × 10−3 mL/cm3/min, while k3 and volume had accuracy of 0.94 (sensitivity = 0.82, specificity = 0.97) and 0.90 (sensitivity = 0.64, specificity = 0.97) respectively. 100% accuracy can be achieved using a multivariate logistic regression model of MRI parameters after thresholding the data with Ki −3 mL/cm3/min. The results of this preliminary study suggest that quantitative MRI may provide additional value in distinguishing metastatic nodes, particularly among small nodes, when used together with FDG-PET.
Databáze: OpenAIRE