Document Detail


Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up.
MedLine Citation:
PMID:  18704401     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We prospectively compared PET/CT and conventional imaging for initial staging of nasopharyngeal carcinoma (NPC). METHODS: A total of 111 patients with histologically proven NPC were investigated with PET/CT and conventional imaging (head-and-neck MRI, chest X-ray, abdominal ultrasound, and bone scan) before treatment. The respective findings were reviewed independently and then compared with each other. RESULTS: With regard to T staging, PET/CT showed a discrepancy with head-and-neck MRI in 36 (32.4%) of the study subjects. With regard to N staging, PET/CT showed a discrepancy with head-and-neck MRI in 15 (13.5%) patients. Among the discordant cases, MRI was superior in demonstrating tumor involvement in the parapharyngeal space, skull base, intracranial area, sphenoid sinus, and retropharyngeal nodes while PET/CT was superior in demonstrating neck nodal metastasis. PET/CT disclosed 13 of 16 patients with distant malignancy compared with four patients disclosed by conventional imaging work-up. The false-positive rate of PET/CT was 18.8%. PET/CT correctly modified M staging in eight patients (7.2%) and disclosed a second primary lung malignancy in one patient (0.9%). CONCLUSION: In NPC patients, MRI appears to be superior to PET/CT for the assessment of locoregional invasion and retropharyngeal nodal metastasis. PET/CT is more accurate than MRI for determining cervical nodal metastasis and should be the better reference for the neck status. PET/CT has an acceptable diagnostic yield and a low false-positive rate for the detection of distant malignancy and can replace conventional work-up to this aim. PET/CT and head-and-neck MRI are suggested for the initial staging of NPC patients.
Authors:
Shu-Hang Ng; Sheng-Chieh Chan; Tzu-Chen Yen; Joseph Tung-Chieh Chang; Chun-Ta Liao; Sheung-Fat Ko; Feng-Yuan Liu; Shu-Chyn Chin; Kang-Hsing Fan; Cheng-Lung Hsu
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-08-15
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  36     ISSN:  1619-7089     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-05     Completed Date:  2009-03-30     Revised Date:  2009-06-16    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  12-22     Citation Subset:  IM    
Affiliation:
Molecular Imaging Center and Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chang Gung University, Kueishan, Taiwan. Shng6@ms25.hinet.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
Lymphatic Metastasis / radiography,  radionuclide imaging
Magnetic Resonance Imaging
Male
Middle Aged
Nasopharyngeal Neoplasms / diagnosis*,  radiography,  radionuclide imaging*,  ultrasonography
Neoplasm Staging / methods*
Positron-Emission Tomography
Tomography, X-Ray Computed
Comments/Corrections
Erratum In:
Eur J Nucl Med Mol Imaging. 2009 Mar;36(3):538

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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