Detection of recurrent nasopharyngeal carcinoma: MR imaging versus CT.

Chong, Vincent; Fan, Y.F.

doi:10.1148/radiology.202.2.9015075

Cited by 117 publications

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“…However, it is a highly frequent epithelial malignancy of the head and neck in southern China and parts of Southeast Asia, with a reported annual incidence of 30-80 per 10 5 persons in endemic regions, mainly owing to Asian ancestry and infection with the Epstein-Barr virus. [1][2][3] The mainstay of treatment for nasopharyngeal cancers is using 100 mg m 22 of cisplatin on Days 1, 22 and 43 concurrent with radiotherapy, followed by adjuvant 80 mg m 22 of cisplatin on Day 1 and 1000 mg m 22 of 5-fluorouracil on Days 1-4 for three cycles. 4,5 It is known that stage-adapted therapy significantly improved the survival of patients with cancer.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of diagnostic value of 18F-FDG PET or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma

Shen¹,

Zhang²,

Jia³

et al. 2014

The British Journal of Radiology

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The authors Guohua Shen and Wenjie Zhang contributed equally to this work.Objective: We performed this meta-analysis to comprehensively assess the diagnostic performance of positron emission tomography (PET) or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma (NPC). Methods: Through a search of four English and three Chinese databases (January 1990 to June 2013), pooled estimated sensitivity, specificity and diagnostic odds ratio (DOR) were calculated based on the data extracted from the included studies. We also constructed summary receiver operating characteristic curves, with the area under the curve (AUC) and obtained the Q* index. Heterogeneity and subgroup analysis were also performed. Conclusion:The present meta-analysis showed that PET or PET/CT has excellent diagnostic performance for detecting lymph node and distant metastases in patients with NPC. Advances in knowledge: To provide evidence to assess the role of PET or PET/CT in staging of NPC.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of diagnostic value of 18F-FDG PET or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma

Shen¹,

Zhang²,

Jia³

et al. 2014

The British Journal of Radiology

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“…Both MRI and CT scans have low sensitivity and moderate specificity for detecting recurrent NPC and for distinguishing recurrence from postradiation therapy changes. 22 However, MRI is superior to CT scans in differentiating postradiation fibrosis from recurrent NPC, although early, distinct differentiation generally is impossible due to immature scars, which, along with well hydrated granulation tissues, generally reveal contrast enhancement. 23 Recently, 18-fluoro-2-deoxyglucose-positron emission tomography (PET) or thallium-201, singlephoton emission CT has been recommended for detecting recurrent NPC, particularly when MRI findings are indeterminate.…”

Section: Discussionmentioning

confidence: 99%

Presence of the latent membrane protein 1 gene in nasopharyngeal swabs from patients with mucosal recurrent nasopharyngeal carcinoma

Tsang

Chuang

Tseng

et al. 2003

Cancer

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BACKGROUNDNasopharyngeal carcinoma (NPC) is the most common head and neck malignancy in southeastern China and Taiwan. Early detection of the local disease followed by timely and appropriate treatment is essential to increasing cure and survival rates. Detection of Epstein–Barr virus (EBV) genomic DNA, such as the latent membrane protein 1 gene (LMP‐1), in patients postirradiation during follow‐up may indicate mucosal recurrence.METHODSSeventy‐one patients with NPC underwent serial nasopharyngeal swabs for LMP‐1 polymerase chain reaction assay before, during, and after irradiation. All of patients achieved a complete disease remission of the LMP‐1 gene after irradiation that lasted for at least 6 months.RESULTSThe median LMP‐1 disease remission time after the beginning of irradiation was 4.3 weeks. Patients with early LMP‐1 disease remission (≤ 4 weeks after the beginning of irradiation) and delayed LMP‐1 disease remission (> 4 weeks) had 3‐year local control rates of 93.5% and 76.9%, respectively (P = 0.0529). The LMP‐1 gene was detected again (reexpression of LMP‐1 [re‐LMP‐1]) in 10 patients after irradiation with at least 6 months of follow‐up. Nine of 10 patients (90%) in the re‐LMP‐1 positive group and 2 of 61 patients (3.3%) in the re‐LMP‐1 negative group developed local recurrence. Mucosal recurrence developed in nine patients, and all displayed re‐LMP‐1. By detecting re‐LMP‐1 using nasopharyngeal swabs, mucosal recurrence was diagnosed with a sensitivity of 100% (9 of 9 patients) and a specificity of 98.4% (61 of 62 patients). The 3‐year overall survival rate, the disease free survival rate for the entire group, and the estimated local mucosal control rates in the re‐LMP‐1 positive and re‐LMP‐1 negative groups were 86.5%, 76.5%, 19.4%, and 96.7%, respectively.CONCLUSIONSExpression of EBV LMP‐1 in nasopharyngeal swab specimens from patients with irradiated/treated NPC can provide a highly sensitive and specific method of forecasting mucosal recurrence. This investigation confirmed the reliability and feasibility of nasopharyngeal swabs in screening for mucosal recurrences in patients with NPC. Cancer 2003. © 2003 American Cancer Society.

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“…This approach is especially useful when results from the follow-up imaging studies are in doubt, because postirradiation tissue changes are seen commonly in patients with NPC after radiotherapy. 15 The source of cell free EBV DNA in circulation of patients with EBV-harboring malignancy remains somewhat controversial. Intact EBV particles 10,16,17 or free EBV DNA molecules released through the process of tumor death 9,12,18 both may exist in the circulation of patients with active disease.…”

Section: Discussionmentioning

confidence: 99%

Detection of cell free Epstein–Barr virus DNA in sera from patients with nasopharyngeal carcinoma

Hsiao

Jin

Tsai

2002

Cancer

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BACKGROUNDThe detection of tumor‐derived DNA within the circulation of patients with malignant disease using polymerase chain reaction (PCR)‐based strategies has opened a new avenue for the diagnosis and monitoring of these patients. Because of the universal association of Epstein–Barr virus (EBV) with the nonsquamous type of nasopharyngeal carcinoma (NPC; World Health Organization types II and III), the detection of cell free EBV DNA in sera from patients with NPC may be a valuable tool for monitoring the progress of tumors or to provide advanced warning of tumor recurrence.METHODSSerum samples were obtained from different patients, and cell free EBV DNA was detected with a conventional PCR approach. A total of 134 patients were sampled, including 36 patients with primary NPC, 28 control patients, 18 patients suffering from locoregional recurrence, 7 patients with distant metastasis, and 45 patients with NPC in clinical remission. A conventional PCR approach employing standard 35‐cycle and 50‐cycle reactions was used to detect cell free EBV genomes. Results from the two PCR cycles were compared to provide a semiquantitative picture of the relative quantity of EBV genome in each serum sample.RESULTSThe EBV DNA detection rates, i.e., the rates of positive detection, for 35‐cycle and 50‐cycle PCR analyses, respectively, were 38.9% and 75% for patients with primary NPC, 3.5% and 10.7% for control patients, 27.8% and 88.9% for patients with locoregional disease recurrence, 71.4% and 100% for patients with distant metastasis, and 7.1% and 36.5% for patients with disease in clinical remission. The rates of positive detection among patients with active disease all appeared to be significantly greater compared with the rates among patients with disease in clinical remission. Longitudinal data for six patients with recurrent tumors revealed a close correlation between the relative quantity of circulating cell free EBV genomes and the disease course of these patients. The sensitivity, specificity, positive predictive value, and negative predictive value of the 50‐cycle PCR analysis for detecting recurrent disease were 92%, 63.5%, 42.6%, and 96.4%, respectively.CONCLUSIONSThis study demonstrated that, by using a 50‐cycle PCR‐based approach, high sensitivity and high negative predictive value for detecting recurrent disease can be obtained from the detection of the cell free EBV genome in sera from patients with NPC. The 50‐cycle PCR analysis, therefore, may provide a simple, clinically useful adjuvant method for monitoring patients with NPC. Cancer 2002;94:723–9. © 2002 American Cancer Society.DOI 10.1002/cncr.10251

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Detection of recurrent nasopharyngeal carcinoma: MR imaging versus CT.

Abstract: Both modalities have relatively low sensitivity and moderate specificity in detection of tumor recurrence and in distinguishing recurrence from post-radiation therapy changes.

Cited by 117 publications

References 0 publications

Meta-analysis of diagnostic value of 18F-FDG PET or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma

Meta-analysis of diagnostic value of 18F-FDG PET or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma

Presence of the latent membrane protein 1 gene in nasopharyngeal swabs from patients with mucosal recurrent nasopharyngeal carcinoma

Detection of cell free Epstein–Barr virus DNA in sera from patients with nasopharyngeal carcinoma

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