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Whole-Body ¹⁸F-FDG PET in Recurrent or Metastatic Nasopharyngeal Carcinoma

¹ Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
² Institute of Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
³ Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

The aim of this retrospective study was to evaluate the sensitivity and prognostic significance of whole-body ¹⁸F-FDG PET for nasopharyngeal carcinoma (NPC) patients for whom there was a suspicion of recurrence or metastasis by conventional radiologic or clinical findings during their follow-up examinations. Methods: Whole-body ¹⁸F-FDG PET examinations were performed on 64 Taiwanese NPC patients (14 female, 50 male; mean age ± SD, 45.8 ± 13.0 y; age range, 16–75 y) 4–70 mo (mean ± SD, 14.1 ± 13.5 mo) after radiotherapy or induction chemotherapy followed by concurrent chemoradiotherapy from February 1997 to May 2001. The accuracy of ¹⁸F-FDG PET detection for each patient was determined by the histopathologic results or other clinical evidence. Results: The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ¹⁸F-FDG PET images in the diagnosis of NPC recurrence or metastases and secondary primary cancers were 92%, 90%, 92%, 90%, and 91%, respectively. Furthermore, the presence of ¹⁸F-FDG hypermetabolism was highly correlated with the survival time of NPC patients. Conclusion: Whole-body ¹⁸F-FDG PET is a sensitive follow-up diagnostic tool for the evaluation of NPC recurrences and metastases. It is also an effective prognostic indicator for NPC patients. To determine the optimized utilization of ¹⁸F-FDG PET in the follow-up for NPC patients, further cost-effectiveness analysis of ¹⁸F-FDG PET in combination with conventional management is necessary.

Key Words: nasopharyngeal carcinoma • whole-body ¹⁸F-FDG PET • survival analysis

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