Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up
Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up
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DOI：
10.1007/s00259-009-1080-6
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发表时间：
2009
影响因子：
9.1
通讯作者：
S. Ng;Sheng-Chieh Chan;T. Yen;J. Chang;C. Liao;S. Ko;Feng-Yuan Liu;S. Chin;K. Fan;Cheng‐Lung Hsu
中科院分区：
文献类型：
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作者：
S. Ng;Sheng-Chieh Chan;T. Yen;J. Chang;C. Liao;S. Ko;Feng-Yuan Liu;S. Chin;K. Fan;Cheng‐Lung Hsu
目的前瞻性比较PET/CT和常规影像学检查对鼻咽癌（NPC）早期分期的诊断价值。方法对111例经病理证实的NPC患者在治疗前进行PET/CT和常规影像学检查（头颈部MRI、胸部X线、腹部超声和骨扫描）。各自的研究结果进行了独立审查，然后比较与other.ResultsWith关于T分期，PET/CT显示的差异与头部和颈部MRI在36（32.4%）的研究对象。关于N分期，PET/CT显示15例（13.5%）患者与头颈部MRI不一致。在不一致的病例中，MRI在显示咽旁间隙、颅底、颅内区域、蝶窦和咽后淋巴结的肿瘤累及方面具有上级优势，而PET/CT在显示颈部淋巴结转移方面具有上级优势。PET/CT显示16例患者中有13例患有远处恶性肿瘤，而常规成像检查显示4例患者。PET/CT假阳性率为18.8%。PET/CT对8例（7.2%）患者的M分期进行了正确修正，1例（0.9%.ConclusionIn NPC patients，MRI在局部浸润和咽后淋巴结转移的评估方面优于PET/CT，但MRI在局部浸润和咽后淋巴结转移的评估方面仍有上级价值。PET/CT对颈部淋巴结转移的判断较MRI更准确，是颈部状况的较好参考。PET/CT对于远处恶性肿瘤的检测具有可接受的诊断率和较低的假阳性率，并且可以替代常规检查达到此目的。PET/CT和头颈部MRI可作为鼻咽癌的初步分期方法。
PurposeWe prospectively compared PET/CT and conventional imaging for initial staging of nasopharyngeal carcinoma (NPC).MethodsA 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.ResultsWith 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%).ConclusionIn 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.