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Locoregional tumour evaluation of squamous cell carcinoma in the head and neck area: a comparison between MRI, PET/CT and integrated PET/MRI

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Abstract

Purpose

To evaluate the accuracy of integrated 18F-FDG PET/MR imaging for locoregional tumour evaluation compared to 18F-FDG PET/CT and MR imaging in initial tumour and recurrence diagnosis in histopathologically confirmed head and neck squamous cell carcinoma (HNSCC).

Methods

18F-FDG PET/CT and integrated 18F-FDG PET/MR imaging were performed for initial tumour staging or recurrence diagnosis in 25 patients with HNSCC. MR, fused 18F-FDG PET/CT and fused 18F-FDG PET/MR images were analysed by two independent readers in separate sessions in random order. In initial tumour staging, T and N staging was performed while individual lesions were analysed in patients with suspected cancer recurrence. In T and N staging, histopathological results after tumour resection served as the reference standard while histopathological sampling as well as cross-sectional and clinical follow-up were accepted in cancer recurrence diagnosis. The diagnostic accuracy of each modality was calculated separately for T and N staging as well as for tumour recurrence, and compared using McNemar’s test. Values of p <0.017 were considered statistically significant after Bonferroni correction.

Results

In 12 patients undergoing 18F-FDG PET/CT and 18F-FDG PET/MR for initial tumour staging, T staging was accurate in 50 % with MRI, in 59 % with PET/CT and in 75 % with PET/MR while N staging was accurate in 75 % with MRI, in 77 % with PET/CT and in 71 % with PET/MR in relation to the reference standard. No significant differences were observed in T and N staging among the three modalities (p > 0.017). In 13 patients undergoing hybrid imaging for cancer recurrence diagnosis, diagnostic accuracy was 57 % with MRI and in 72 % with 18F-FDG PET/CT and 18F-FDG PET/MR, respectively. Again, no significant differences were found among the three modalities (p > 0.017).

Conclusion

In this initial study, no significant differences were found among 18F-FDG PET/MR, 18F-FDG PET/CT and MRI in local tumour staging and cancer recurrence diagnosis.

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Compliance with ethical standars

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Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany

    Benedikt Michael Schaarschmidt, Philipp Heusch, Christian Buchbender & Gerald Antoch

  2. Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, 45147, Essen, Germany

    Benedikt Michael Schaarschmidt, Marc Schlamann, Michael Forsting & Axel Wetter

  3. Medical Faculty, Department of Nuclear Medicine, University Duisburg-Essen, 45147, Essen, Germany

    Marcus Ruhlmann & Verena Ruhlmann

  4. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Essen, 45147, Essen, Germany

    Christoph Bergmann

  5. Department of Neuroradiology, University Hospital Giessen, Marburg, Germany

    Marc Schlamann

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  1. Benedikt Michael Schaarschmidt
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  2. Philipp Heusch
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Correspondence to Benedikt Michael Schaarschmidt.

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Schaarschmidt, B.M., Heusch, P., Buchbender, C. et al. Locoregional tumour evaluation of squamous cell carcinoma in the head and neck area: a comparison between MRI, PET/CT and integrated PET/MRI. Eur J Nucl Med Mol Imaging 43, 92–102 (2016). https://doi.org/10.1007/s00259-015-3145-z

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  • DOI: https://doi.org/10.1007/s00259-015-3145-z

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