FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review

Liu, Tao; Xu, Wen; Yan, Weili; Ye, Ming; Bai, Yongrui; Huang, Gang

doi:10.1016/j.radonc.2007.11.002

Cited by 108 publications

(61 citation statements)

References 33 publications

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“…However, in a recent review of trials evaluating PET for detecting residual or recurrent HNSCC in undifferentiated patients treated by radiotherapy or chemoradiotherapy, among 27 of 1,871 identified studies the pooled sensitivity and specificity of PET for detecting residual or recurrent HNSCC were 94% and 82%, respectively, whereas the CT mean pooled sensitivity and specificity were lower (67% and 78%, respectively), as were the sensitivity and specificity of MRI (81% and 46%, respectively) (22). In another recent review of 21 articles comparing 18 F-FDG PET, CT, and MRI for the diagnosis of local residual or recurrent nasopharyngeal carcinoma, the pooled sensitivity estimates for PET (95%) were significantly higher than those for CT (76%) (P , 0.001) or MRI (78%) (P , 0.001) and the pooled specificity estimates for PET (90%) were significantly higher than those for CT (59%) (P , 0.001) or MRI (76%) (P , 0.001) (23). Moreover, in a prospective study comparing 18 F-FDG PET, CT, and MRI for the initial evaluation of 134 oral SCC patients with a palpably negative neck, Ng et al found 18 F-FDG PET to have a sensitivity 2-fold higher than CT or MRI in the detection of nodal metastases (41.2% vs. 21.6%, respectively; P 5 0.021) (24).…”

Section: Resultsmentioning

confidence: 90%

Does ¹⁸F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?

Abgral¹,

Querellou²,

Potard³

et al. 2008

J Nucl Med

228

192

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Posttreatment surveillance for the recurrence of head and neck squamous cell carcinoma (HNSCC) is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination, CT, and MRI. Several studies have shown that 18 F-FDG PET may be an effective technique for the detection of persistent, recurrent, and distant metastatic HNSCC after treatment. The aim of this prospective study was to determine the benefits of hybrid 18 F-FDG PET/CT in detecting a subclinical locoregional recurrence of HNSCC and distant metastases. The study patients were considered cured of HNSCC on the basis of 12 mo of negative findings on conventional follow-up. We also assessed the diagnostic accuracy of 18 F-FDG PET/CT in these patients. Methods: Ninety-one patients cured of HNSCC without any clinical evidence of recurrence were included. Whole-body 18 F-FDG PET/CT examination was performed 11.6 6 4.4 mo after the end of the treatment. The gold standard was histopathology or 6 mo of imaging follow-up. Results: The whole-body 18 F-FDG PET/CT examinations had negative results in 52 patients and positive results in 39. Nine of these patients who exhibited abnormal 18 F-FDG uptake in the head and neck area did not have recurrent HNSCC (false-positive). Thirty had proven recurrence. The sensitivity and specificity of 18 F-FDG PET/CT in this study for the diagnosis of HNSCC recurrence were 100% (30/30) and 85% (52/61), respectively. The positive predictive value was 77% (30/39). The negative predictive value was 100% (52/52). The overall accuracy was 90% (82/91). Conclusion: The results of our study confirm the high effectiveness of 18 F-FDG PET/CT in the assessment of HNSCC recurrence and suggest that 18 F-FDG PET/CT is more accurate than conventional follow-up physical examination alone in the assessment of recurrence after previous curative treatment for HNSCC and could be proposed systematically at 12 mo of the usual follow-up.

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Section: Resultsmentioning

confidence: 90%

Does ¹⁸F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?

Abgral¹,

Querellou²,

Potard³

et al. 2008

J Nucl Med

228

192

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“…In a meta-analysis of 21 high-quality articles, Liu et al 26 compared the accuracy of ct, mri, and fdg-pet/ct for diagnosing local residual disease and rnpc, reporting that fdgpet/ct had a higher sensitivity and specificity (95%, 90%) than either ct (76%, 59%) or mri (78%, 76%). However, increased fdg uptake is easily confused with an inflammatory reaction and may produce false-positive results.…”

Section: Early Detection and Accurate Diagnosismentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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Recurrent nasopharyngeal carcinoma, which represents a small proportion of head-and-neck cancers, has a unique set of patho-clinical characteristics. The management of recurrent nasopharyngeal carcinoma remains a challenging clinical problem. Traditional treatments offer limited local control and survival benefits; more seriously, they frequently induce severe late complications. Recently, novel treatment techniques and strategies—including precision radiotherapy, endoscopic surgery or transoral robotic resection, third-generation chemotherapy regimens, and targeted therapies and immunotherapy—have provided new hope for patients with recurrent nasopharyngeal carcinoma. Some of these patients can potentially be cured with modern treatments. However, a lack of adequate evidence makes it difficult for clinicians to apply these powerful techniques and strategies. Individualized management guidelines, full evaluation of quality of life in these patients, and a further understanding of the mechanisms underlying recurrence are future directions for research into recurrent nasopharyngeal carcinoma.

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“…However, CT is inferior to MRI for delineating soft tissue involvement, and it is often difficult to differentiate NPC from hypertrophied lymphoid tissue. For patients with advanced N3 nodal stage and/or clinical evidence of distant metastases, positron emission tomography-computed tomography (PET-CT) may be performed [7,22].PET has been shown to be superior to CT and MRI for the detection of nodal disease, as well as for the diagnosis of local residual or recurrent NPC [23,24]. A study by Comoretto et al demonstrated that the combined use of MRI and FDG PET-CT had a greater diagnostic accuracy for detecting residual or recurrent disease compared to either modality individually [25].…”

Section: Role Of Imagingmentioning

confidence: 99%

“…A study by Comoretto et al demonstrated that the combined use of MRI and FDG PET-CT had a greater diagnostic accuracy for detecting residual or recurrent disease compared to either modality individually [25]. In addition, PET is reportedly useful for differentiating recurrent NPC tumors from post-radiation changes, such as tissue necrosis, fibrosis and edema [23,[26][27][28][29]. However, in the early postradiation period, FDG uptake can be elevated secondary to inflammation following radiotherapy.…”

Section: Role Of Imagingmentioning

confidence: 99%

Imaging of Nasopharyngeal Carcinoma

Chan

Sahgal

Fatterpekar

et al. 2014

J Nasopharyng Carcinoma

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Nasopharyngeal carcinoma (NPC) is the most common primary neoplasm to arise in the nasopharynx. It is an aggressive tumor with a propensity for local tumour invasion and a high incidence of metastases to cervical lymph nodes. Due to its central location in the nasopharynx, primary tumours have many potential routes of local spread, including into important spaces such as the orbital and intracranial spread. This article discusses the current imaging techniques used in the diagnosis and staging of nasopharyngeal carcinoma, and reviews the 7 th edition of the International Union Against Cancer (UICC) and American Joint Committee on Cancer (AJCC) TMN staging system for nasopharyngeal carcinoma.

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FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review

Cited by 108 publications

References 33 publications

Does ¹⁸F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?

Does ¹⁸F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Imaging of Nasopharyngeal Carcinoma

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FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review

Cited by 108 publications

References 33 publications

Does 18F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?

Does 18F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Imaging of Nasopharyngeal Carcinoma

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Does ¹⁸F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?

Does ¹⁸F-FDG PET/CT Improve the Detection of Posttreatment Recurrence of Head and Neck Squamous Cell Carcinoma in Patients Negative for Disease on Clinical Follow-up?