Head-to-Head Comparison of Chest X-Ray/Head and Neck MRI, Chest CT/Head and Neck MRI, and 18F-FDG PET/CT for Detection of Distant Metastases and Synchronous Cancer in Oral, Pharyngeal, and Laryngeal Cancer

Autor: Abass Alavi, Anders Thomassen, Poul Flemming Høilund-Carlsen, Janus Mølgaard Christiansen, Christian Godballe, Anne Lerberg Nielsen, Jørgen Johansen, Max Rohde, Jens Ahm Sørensen, Nina N. T. T. Nguyen, Anabel Diaz, Jon Thor Asmussen, Oke Gerke, Mie K. Nielsen
Rok vydání: 2017
Předmět:
Male
Thorax
Neoplasm Metastasis/diagnostic imaging
HNSCC
Neck/diagnostic imaging
030218 nuclear medicine & medical imaging
Cohort Studies
0302 clinical medicine
Mouth Neoplasms/diagnostic imaging
Prospective Studies
Aged
80 and over
Thorax/diagnostic imaging
Mouth neoplasm
Laryngeal Neoplasms/diagnostic imaging
medicine.diagnostic_test
Middle Aged
Magnetic Resonance Imaging
Distant metastases
Positron emission tomography
030220 oncology & carcinogenesis
Female
Radiology
Synchronous cancer
MRI
Adult
medicine.medical_specialty
PET/CT
Young Adult
03 medical and health sciences
Fluorodeoxyglucose F18
Journal Article
medicine
Humans
Radiology
Nuclear Medicine and imaging
Aged
PET-CT
Head/diagnostic imaging
business.industry
Detection rate
Reproducibility of Results
Cancer
Magnetic resonance imaging
medicine.disease
Head and neck squamous-cell carcinoma
Radiography
Pharyngeal Neoplasms/diagnostic imaging
Positron-Emission Tomography
Radiopharmaceuticals
Oral pharyngeal
Tomography
X-Ray Computed
business
Zdroj: Rohde, M, Nielsen, A L, Johansen, J, Sørensen, J A, Nguyen, N N T T, Diaz, A, Nielsen, M K, Asmussen, J T, Christiansen, J M, Gerke, O, Thomassen, A, Alavi, A, Høilund-Carlsen, P F & Godballe, C 2017, ' Head-to-head comparison of chest x-ray/head and neck MRI, chest CT/head and neck MRI, and (18)F-FDG-PET/CT for detection of distant metastases and synchronous cancer in oral, pharyngeal, and laryngeal Cancer ', Journal of Nuclear Medicine, vol. 58, no. 12, pp. 1919-1924 . https://doi.org/10.2967/jnumed.117.189704
ISSN: 2159-662X
0161-5505
DOI: 10.2967/jnumed.117.189704
Popis: The purpose of this study was to determine the detection rate of distant metastasis and synchronous cancer, comparing clinically used imaging strategies based on chest x-ray 1 head and neck MRI (CXR/MRI) and chest CT 1 head and neck MRI (CHCT/MRI) with 18F-FDG PET/CT upfront in the diagnostic workup of patients with oral, pharyngeal, or laryngeal cancer. Methods: This was a prospective cohort study based on paired data. Consecutive patients with histologically verified primary head and squamous cell carcinoma at Odense University Hospital from September 2013 to March 2016 were considered for the study. Included patients underwent CXR/MRI and CHCT/MRI as well as PET/CT on the same day and before biopsy. Scans were read masked by separate teams of experienced nuclear physicians or radiologists. The true detection rate of distant metastasis and synchronous cancer was assessed for CXR/MRI, CHCT/MRI, and PET/CT. Results: A total of 307 patients were included. CXR/MRI correctly detected 3 (1%) patients with distant metastasis, CHCT/MRI detected 11 (4%) patients, and PET/CT detected 18 (6%) patients. The absolute differences of 5% and 2%, respectively, were statistically significant in favor of PET/CT. Also, PET/CT correctly detected 25 (8%) synchronous cancers, which was significantly more than CXR/MRI (3 patients, 1%) and CHCT/MRI (6 patients, 2%). The true detection rate of distant metastasis or synchronous cancer with PET/CT was 13% (40 patients), which was significantly higher than 2% (6 patients) for CXR/ MRI and 6% (17 patients) for CHCT/MRI. Conclusion: A clinical imaging strategy based on PET/CT demonstrated a significantly higher detection rate of distant metastasis or synchronous cancer than strategies in current clinical imaging guidelines, of which European ones primarily recommend CXR/MRI, whereas U.S. guidelines preferably point to CHCT/MRI in patients with head and neck squamous cell carcinoma.
Databáze: OpenAIRE
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