Can Parameters Other Than Minimal Axial Diameter in MRI and PET/CT Further Improve the Diagnostic Accuracy of Equivocal Retropharyngeal Lymph Nodes in Nasopharyngeal Carcinoma?

Wang, Y.W.; Lin, K.R.; Chang, Chih-Han; Cheng, Kuo-Sheng; Yao, Wei Jen

doi:10.1016/j.ijrobp.2016.06.1530

Cited by 2 publications

(11 citation statements)

References 38 publications

(51 reference statements)

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“…However, the common advantage of both cohorts for multistage method over a single parameter was the enhancement of speci city and sensitivity, different from shifting a single cutoff value from 5 mm to 6 mm that results in the sacri ce of sensitivity. Table 3 Results of multistage and two conventional criteria for 410 nodes in our previous report [23].…”

Section: Discussionmentioning

confidence: 99%

“…MRI and FDG PET/CT scans were conducted less than 3 weeks apart (mean ± SD = 2.5 ± 6.0; range: 0-17 days) before cancer treatment. The details of imaging protocols for MRI (Siemens Medical Systems, Erlangen, Germany) and PET/CT (GE Healthcare, Chicago, IL, USA) and the methods of measurement of nodal parameters were identical to those described in our previous reports [23,24]. Three experienced NPC physicians (Yu-Wen Wang, Yu-Cheng Hung, and Yu-Kang Chang) evaluated the data in this study.…”

Section: Imaging Protocol and Assessmentmentioning

confidence: 99%

“…Overall, the follow-up period after RT ranged from 0.2 month to 84.4 months (mean ± SD = 30.1 ± 20.9). We measured the changes in MAAD and MACD before and after the treatment to determine the nature of nodes [23,25]. The responsive nodes and those that progressed during follow-up were positive; otherwise, the nodes were considered negative (Fig.…”

Section: Follow-up and Assessment Of Lymph Nodesmentioning

confidence: 99%

“…Currently, we think that the optimal conventional method with a single parameter criterion (MIAD ≥ 6.0 mm) yielded positive results, although we also tested the outcome results by using MIAD ≥ 5.0 mm for comparison [13][14][15]23]. The proposed new criteria with the multistage approach included MIAD and SUV mean as factor from PET scan and other parameters from MRI (MAAD and MACD).…”

Section: Follow-up and Assessment Of Lymph Nodesmentioning

confidence: 99%

“…FDG PET/CT, with its functional imaging sensitivity in detecting cancerous nodal lesions, may be complementary to MRI, which was highly encouraged in the 2017 American Joint Committee on Cancer (AJCC) staging system [22]. Previously, we proposed a new set of diagnostic criteria of parameters combined mean standard uptake value (SUV mean ) from PET/CT and MR (MIAD, maximal axial diameter (MAAD), and maximal coronal diameter (MACD)) with a signi cant higher reported accuracy although an external cohort validation may be warranted [23]. Using a multistage approach to assess a node in daily practice is cumbersome.…”

Section: Introductionmentioning

confidence: 99%

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Verification of the Efficacy of New Diagnostic Criteria for Retropharyngeal Nodes in a Cohort of Nasopharyngeal Carcinoma Patients

Chen

Yao

et al. 2020

Preprint

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Background: A multistage approach to diagnose lateral retropharyngeal nodes (LRPNs) of nasopharyngeal carcinoma (NPC) had been proposed and warranted for validation. Methods: From 2012 to 2017, we collected NPC cases with LRPNs before radiotherapy-based treatments. The responsive nodes or those that progressed during follow-up were positive. The proposed criteria for the multistage approach delimited LRPNs with a minimal axial diameter (MIAD) ≥ 6.1 mm were positive and if the mean standard uptake value ≥ 2.6, or if the maximal coronal diameter ≥ 25 mm and maximal axial diameter ≥ 8 mm with nodes MIAD < 6.1 mm were also positive. The outcomes were compared with the MIAD cutoff value ≥ 6 mm (traditional method). Chi-squared test was used to compare two areas under the curve (AUC) of receiver operating characteristic curves. Results: A total of 67 eligible NPC cases and 155 LRPNs (72 positive and 83 negative) were analyzed. The accuracy, specificity, and sensitivity of the traditional method were 0.91, 0.93, and 0.89, respectively. The values for the multistage approach all reached 0.94. The AUC was significantly greater for the multistage approach compared with that for the traditional method (p = 0.023). Conclusion: The results of LRPN data in this cohort of patients support the advantage of the multistage approach.

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Section: Discussionmentioning

confidence: 99%

Section: Imaging Protocol and Assessmentmentioning

confidence: 99%

Section: Follow-up and Assessment Of Lymph Nodesmentioning

confidence: 99%

Section: Follow-up and Assessment Of Lymph Nodesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Verification of the Efficacy of New Diagnostic Criteria for Retropharyngeal Nodes in a Cohort of Nasopharyngeal Carcinoma Patients

Chen

Yao

et al. 2020

Preprint

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Arterial spin labeling and diffusion-weighted imaging for identification of retropharyngeal lymph nodes in patients with nasopharyngeal carcinoma

Yang

et al. 2022

Cancer Imaging

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Background To evaluate the parameters derived from arterial spin labeling (ASL) and multi-b-value diffusion-weighted imaging (DWI) for differentiating retropharyngeal lymph nodes (RLNs) in patients with nasopharyngeal carcinoma (NPC). Methods This prospective study included 50 newly diagnosed NPC and 23 healthy control (HC) participants. RLNs of NPC were diagnosed according to the follow-up MRI after radiotherapy. Parameters derived from ASL and multi-b-value DWI, and RLNs axial size on pre-treatment MRI among groups were compared. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic efficiency. Results A total of 133 RLNs were collected and divided into a metastatic group (n = 71) and two non-metastatic groups (n = 62, including 29 nodes from NPC and 33 nodes from HC). The axial size, blood flow (BF), and apparent diffusion coefficient (ADC) of RLNs were significantly different between the metastasis and the non-metastasis group. For NPC patients with a short axis < 5 mm or < 6 mm, or long axis < 7 mm, if BF > 54 mL/min/100 g or ADC ≤ 0.95 × 10−3 mm2/s, the RLNs were still considered metastatic. Compared with the index alone, a combination of size and functional parameters could improve the accuracy significantly, except the long axis combined with ADC; especially, combined size with BF exhibited better performance with an accuracy of 91.00–92.00%. Conclusions ASL and multi-b-value DWI could help determine the N stage of NPC, while the BF combination with RLNs size may significantly improve the diagnostic efficiency.

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Can Parameters Other Than Minimal Axial Diameter in MRI and PET/CT Further Improve the Diagnostic Accuracy of Equivocal Retropharyngeal Lymph Nodes in Nasopharyngeal Carcinoma?

Cited by 2 publications

References 38 publications

Verification of the Efficacy of New Diagnostic Criteria for Retropharyngeal Nodes in a Cohort of Nasopharyngeal Carcinoma Patients

Verification of the Efficacy of New Diagnostic Criteria for Retropharyngeal Nodes in a Cohort of Nasopharyngeal Carcinoma Patients

Arterial spin labeling and diffusion-weighted imaging for identification of retropharyngeal lymph nodes in patients with nasopharyngeal carcinoma

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