MRI detection of suspected nasopharyngeal carcinoma: a systematic review and meta-analysis

Abstract

Purpose Endoscopic biopsy is recommended for diagnosis of nasopharyngeal carcinoma (NPC). A proportion of lesions are hidden from endoscopic view but detected with magnetic resonance imaging (MRI). This systematic review and meta-analysis investigated the diagnostic performance of MRI for detection of NPC. Methods An electronic search of twelve databases and registries was performed. Studies were included if they compared the diagnostic accuracy of MRI to a reference standard (histopathology) in patients suspected of having NPC. The primary outcome was accuracy for detection of NPC. Random-effects models were used to pool outcomes for sensitivity, specificity, and positive and negative likelihood ratio (LR). Bias and applicability were assessed using the modified QUADAS-2 tool. Results Nine studies were included involving 1736 patients of whom 337 were diagnosed with NPC. MRI demonstrated a pooled sensitivity of 98.1% (95% CI 95.2–99.3%), specificity of 91.7% (95% CI 88.3–94.2%), negative LR of 0.02 (95% CI 0.01–0.05), and positive LR of 11.9 (95% CI 8.35–16.81) for detection of NPC. Most studies were performed in regions where NPC is endemic, and there was a risk of selection bias due to inclusion of retrospective studies and one case–control study. There was limited reporting of study randomization strategy. Conclusion This study demonstrates that MRI has a high pooled sensitivity, specificity, and negative predictive value for detection of NPC. MRI may be useful for lesion detection prior to endoscopic biopsy and aid the decision to avoid biopsy in patients with a low post-test probability of disease.

The utility of texture analysis based on quantitative synthetic magnetic resonance imaging in nasopharyngeal carcinoma: a preliminary study

“…Endoscopic biopsy is the gold standard for diagnosis of NPC. However, this examination method is invasive and it may miss some lesions generally attributed to submucosal location, coexistent hyperplasia, and difficult pharyngeal recess structure [ 30 , 31 ]. About 12% of NPC invisible under endoscopy can be successfully detected by MRI [ 32 ].…”

Precision medicine in nasopharyngeal carcinoma: comprehensive review of past, present, and future prospect

“…It had also detected 10% of hidden tumor from endoscopic view [ 44 ]. Another study with high sensitivity (98.1%) and specificity (91.7%) for lesion detection has suggested that MRI can be the primary diagnostic tool for NPC detection [ 45 ].…”

The role and molecular mechanism of NOP16 in the pathogenesis of nasopharyngeal carcinoma

“…NPC is usually diagnosed by nuclear magnetic resonance or CT imaging methods, as well as living sections of nasopharyngeal tissue. 6 Blood tests may also be used to detect antibodies to the Epstein-Barr virus (EBV). 7 According to the development of the disease, there are different methods for the treatment of NPC cells, such as surgery, radiotherapy and chemotherapy.…”

“…These symptoms may be nonspecific and can be mistaken for other conditions, such as a respiratory infection or allergies. NPC is usually diagnosed by nuclear magnetic resonance or CT imaging methods, as well as living sections of nasopharyngeal tissue 6 . Blood tests may also be used to detect antibodies to the Epstein‒Barr virus (EBV) 7 .…”