Is integrated 18F-FDG PET/MRI superior to 18F-FDG PET/CT in the differentiation of incidental tracer uptake in the head and neck area?

Schaarschmidt, Benedikt Michael; Gomez, Benedikt; Buchbender, Christian; Grueneisen, Johannes; Nensa, Felix; Sawicki, L; Ruhlmann, Verena; Wetter, Axel; Antoch, Gerald; Heusch, Philipp

doi:10.5152/dir.2016.15610

Cited by 11 publications

(4 citation statements)

References 29 publications

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“…To this day, several studies have debated on the added value of PET/MR imaging compared with PET/CT in HNC evaluation. Although some studies found no advantages of PET/MR imaging in terms of diagnostic performance, 16,[18][19][20] others showed it to be advantageous in terms of overall diagnostic accuracy 21 or of tumor delineation, 22 which is particularly relevant in the head and neck region, where anatomic landmarks are complex and mobile because of patients positioning differences between examinations. 23 Additionally, coregistration procedures between PET/CT and MR imaging are usually performed in studies conducted for research purposes, being less feasible in clinical practice using routine algorithms.…”

Section: Discussionmentioning

confidence: 99%

Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Pyatigorskaya

Laroche

Bera

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: PET/MRI with 18 F-FDG has demonstrated the advantages of simultaneous PET and MR imaging in head and neck cancer imaging, MRI allowing excellent soft-tissue contrast, while PET provides metabolic information. The aim of this study was to evaluate the added value of gadolinium contrast-enhanced sequences in the tumor delineation of head and neck cancers on 18 F-FDG-PET/MR imaging. MATERIALS AND METHODS:Consecutive patients who underwent simultaneous head and neck 18 F-FDG-PET/MR imaging staging or restaging followed by surgery were retrospectively included. Local tumor invasion and lymph node extension were assessed in 45 head and neck anatomic regions using 18 F-FDG-PET/MR imaging by 2 rater groups (each one including a radiologist and a nuclear medicine physician). Two reading sessions were performed, one without contrast-enhanced sequences (using only T1WI, T2WI, and PET images) and a second with additional T1WI postcontrast sequences. The results were compared with the detailed histopathologic analysis, used as reference standard. The k concordance coefficient between the reading sessions and sensitivity and specificity for each region were calculated.

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Section: Discussionmentioning

confidence: 99%

Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Pyatigorskaya

Laroche

Bera

et al. 2020

AJNR Am J Neuroradiol

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“…However, to the best of our knowledge, no studies have investigated incidental FDG uptake in the oropharynx specifically. Incidental PET uptake in the head and neck was analysed in 16 papers and was shown to occur in 13.8% of scans on average (Table 4) [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. The presence of PET incidentalomas was associated with a significant increase in time to commencement of treatment [14].…”

Section: Discussionmentioning

confidence: 99%

Incidental uptake of fluorodeoxyglucose in the Waldeyer’s ring and risk of oropharyngeal malignancy

Bujoreanu

Gujral

Wallitt

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Fluorodeoxyglucose (FDG) positron emission tomography (PET) is increasingly used to diagnose and stage malignancy. The aim of this article is to investigate the significance of incidental FDG uptake in the Waldeyer’s ring and to assess its value in predicting clinically occult oropharyngeal malignancy. Methods All FDG-PET/CT scans performed in Imperial College NHS Foundation Trust, UK between January 2012 and November 2018 were included. Patients with known or suspected oropharyngeal malignancy or lymphoma were excluded. Minimum follow-up was 12 months. Results A total of 724 scans revealed oropharyngeal uptake of FDG. Of these, 102 were included in the study. Most patients (62.1%) were scanned as part of staging for other malignancies. Oropharyngeal FDG uptake was asymmetrical in 57.3% of the cases. Uptake was more common in the tonsils (56.3%), followed by the tongue base (31.1%) and both sites (12.6%). In 41.7% of reports, appearance was described as likely physiological; however, 52.4% of reports advised direct visualisation, clinical correlation or ENT opinion. Only 24.3% (25/102) of patients were referred and seen by ENT, 14.6% (15/102) of which had an interval PET scan and 8.7% (9/102) proceeded to tissue diagnosis. There was one oropharyngeal cancer identified and one unexpected metastasis from esophageal cancer. Conclusion Incidental uptake on PET/CT in the oropharynx is common. However, malignancy is rare (1.9%) and, when present, is associated with high SUVmax and asymmetrical uptake. Imaging results must be correlated clinically. These patients should be seen by an ENT specialist yet most may not require further investigations.

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“…39 A retrospective analysis by Schaarschmidt et al showed no significant difference in correct classification of incidental radiotracer uptake in the head and neck on PET/MRI compared to PET/CT in 81 oncologic patients. 40 In a separate publication, Schaarschmidt et al also noted no significant difference between PET/MRI, PET/CT, and MRI in local tumor staging or cancer recurrence in a small study of 25 patients. 41…”

Section: Follow-up Imaging and Disease Recurrencementioning

confidence: 95%

PET/MRI vs PET/CT in Head and Neck Imaging: When, Why, and How?

Ryan

Aaron

Sims

2019

Seminars in Ultrasound, CT and MRI

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The increasing availability of hybrid PET/MRI systems has led to a breadth of new publications and opportunities for use of PET/MRI. While PET/CT has been a valuable tool for oncologic staging, including head and neck malignancy, there are several theoretical and practical advantages a PET/MRI system would have over PET/CT in head and neck imaging. This review article discusses the established role of PET/CT, early evidence for the role of PET/MRI, and protocol considerations for both PET/CT and PET/MRI as they apply to head and neck imaging.

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Is integrated 18F-FDG PET/MRI superior to 18F-FDG PET/CT in the differentiation of incidental tracer uptake in the head and neck area?

Cited by 11 publications

References 29 publications

Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Incidental uptake of fluorodeoxyglucose in the Waldeyer’s ring and risk of oropharyngeal malignancy

PET/MRI vs PET/CT in Head and Neck Imaging: When, Why, and How?

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Is integrated 18F-FDG PET/MRI superior to 18F-FDG PET/CT in the differentiation of incidental tracer uptake in the head and neck area?

Cited by 11 publications

References 29 publications

Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous 18F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous 18F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Incidental uptake of fluorodeoxyglucose in the Waldeyer’s ring and risk of oropharyngeal malignancy

PET/MRI vs PET/CT in Head and Neck Imaging: When, Why, and How?

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Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?