Staging and follow-up of nasopharyngeal carcinoma: Magnetic resonance imaging versus computerized tomography

Olmi, Patrizia; Fallai, C.; Colagrande, Stefano; Giannardi, G

doi:10.1016/0360-3016(94)00535-s

Cited by 118 publications

(68 citation statements)

References 15 publications

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“…The superior soft tissue contrast of MRI could be of paramount importance in discriminating individual lymph nodes from direct tumor extension and oropharyngeal involvement (30,31). In contrast, CT is unable to depict the small soft tissue structure and might lead to diagnoses with a higher incidence of parapharyngeal and oropharyngeal involvement and lesser incidence of bony structures involvement than MRI (22,30,32).…”

Section: Discussionmentioning

confidence: 99%

Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma: Prognostic Value and Staging Categories

Ma¹,

Liu²,

Tang³

et al. 2007

Clinical Cancer Research

106

102

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Purpose: To investigate the incidence, prognostic value, and staging categories of retropharyngeal lymph node (RLN) metastasis in nasopharyngeal carcinoma (NPC). Experimental Design: We did a retrospective review of the data from 749 biopsy-proved nonmetastatic NPC patients. All patients had undergone contrast-enhanced computed tomography and had radiotherapy as their primary treatment. Results:The incidence of RLN metastasis was 51.5%. After adjusting for tumor (T) and node (N) classifications, a borderline significant difference of distant metastasis-free survival (DMFS) rates was observed between patients with or without RLN metastasis. In N 0 disease, the presence of RLN metastasis was a significant independent predictor for overall survival (OS), loco-regional relapse-free survival, and DMFS in multivariate Cox modeling analysis. No significant difference was observed in all end points between patients with unilateral and bilateral RLN metastasis. The hazard ratios of death and distant failure for N 0 with RLN metastasis were similar to N 1 . The survival curve of OS and DMFS for N 0 disease with RLN metastasis had approximated that of N 1 disease. The survival curve of OS for T 1 disease with RLN metastasis was approximately the same as T 2 disease. However, the survival curve of DMFS for T 1 disease with RLN metastasis was approximately the same as inT 3 disease. Conclusions: RLN metastasis has a tendency to affect the DMFS rates of patients with NPC. Retropharyngeal node involvement has a negative effect on the prognosis of N 0 disease. RLN metastasis should be classified as N 1 .

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Section: Discussionmentioning

confidence: 99%

Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma: Prognostic Value and Staging Categories

Ma¹,

Liu²,

Tang³

et al. 2007

Clinical Cancer Research

106

102

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“…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. 24 Even if functional imaging can provide good sensitivity and specificity, numerous economic and practical problems limit its usefulness in detecting recurrence in the nasopharynx, particularly when an early diagnosis is desired.…”

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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“…MR imaging has been used to stage biopsy-proved NPC for nearly 20 years, [6][7][8] but it is also ideally suited for the initial detection of the primary tumor. 9 In a previous prospective NPCdetection study, 10 we compared the diagnostic accuracy of nasopharyngeal MR imaging with that of nasopharyngeal endoscopy and endoscopic biopsy.…”

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confidence: 99%

Detection of Nasopharyngeal Carcinoma by MR Imaging: Diagnostic Accuracy of MRI Compared with Endoscopy and Endoscopic Biopsy Based on Long-Term Follow-Up

King¹,

Vlantis²,

Yuen³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Our previous nasopharyngeal carcinoma detection study, comparing MR imaging, endoscopy, and endoscopic biopsy, showed that MR imaging is a highly sensitive test that identifies nasopharyngeal carcinomas missed by endoscopy. However, at the close of that study, patients without biopsy-proved nasopharyngeal carcinoma nevertheless had shown suspicious abnormalities on endoscopy and/or MR imaging. The aim of this study was to determine whether there were any patients with undiagnosed nasopharyngeal carcinoma by obtaining long-term follow-up and to use these data to re-evaluate the diagnostic performance of MR imaging.

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Staging and follow-up of nasopharyngeal carcinoma: Magnetic resonance imaging versus computerized tomography

Cited by 118 publications

References 15 publications

Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma: Prognostic Value and Staging Categories

Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma: Prognostic Value and Staging Categories

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

Detection of Nasopharyngeal Carcinoma by MR Imaging: Diagnostic Accuracy of MRI Compared with Endoscopy and Endoscopic Biopsy Based on Long-Term Follow-Up

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