Diagnostic accuracy of ultrasound, 18F-FDG-PET/CT, and fused 18F-FDG-PET-MR images with DWI for the detection of cervical lymph node metastases of ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-07-27

AUTHORS

Philipp Heusch, Christoph Sproll, Christian Buchbender, Elena Rieser, Jan Terjung, Christina Antke, Inga Boeck, Stephan Macht, Axel Scherer, Gerald Antoch, Till A. Heusner, Jörg Handschel

ABSTRACT

ObjectiveThis study aimed to compare 18F-fluorodesoxyglucose positron emission tomography/MRI (18F-FDG-PET-MRI) fusion images, including diffusion-weighted imaging (DWI), 18F-FDG-PET/CT, and ultrasound (US) regarding their performance in nodal staging of patients with head and neck squamous cell carcinoma (HNSCC).Materials and methodsEighteen patients prospectively underwent ultrasound examination, 18F-FDG- PET/CT, and MRI before oral tumor resection and bilateral neck dissection. PET data sets were fused with contrast-enhanced T1-weighted MR images. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for nodal detection were calculated for all the imaging modalities. Furthermore, the accuracy of the correct N-staging was calculated for all methods. Detailed histopathology served as the standard of reference.ResultsThe sensitivity, specificity, PPV, NPV, and accuracy for detection of lymph node metastases were 63, 99, 86, 96, and 95 % for ultrasound; 30, 97, 56, 92, and 90 % for 18F-FDG-PET/CT; 52, 96, 59, 94, and 91 % for 18F-FDG-PET-MRI; and 53, 97, 67, 95, and 92 % for 18F-FDG-PET-MRI plus DWI, respectively. There was no significant difference in the diagnostic accuracy for lymph node metastasis detection between 18F-FDG-PET-MRI and 18F-FDG-PET/CT (p = 0.839) and between 18F-FDG-PET-MRI plus DWI and 18F-FDG-PET/CT (p = 0.286), respectively. US was significantly more accurate than 18F-FDG-PET/CT (p = 0.009), whereas no significant difference was seen between 18F-FDG-PET-MRI and US (p = 0.223) or 18F-FDG-PET-MRI plus DWI and US (p = 0.115). The nodal stage was correctly rated by 18F-FDG-PET-MRI in eight patients, 18F-FDG-PET-MRI plus DWI in nine patients, US in 12 patients, and 18F-FDG-PET/CT in five out of 18 patients.ConclusionSoftware-based fusion of 18F-FDG-PET-MRI and 18F-FDG-PET-MRI plus DWI may not increase nodal detection and N-staging performance in patients with oral malignancies compared to US and 18F-FDG-PET/CT.Clinical relevanceSurgical staging of cervical lymph nodes will not be replaced even by advanced imaging modalities in the near future. More... »

PAGES

969-978

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00784-013-1050-z

DOI

http://dx.doi.org/10.1007/s00784-013-1050-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1029513102

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23892450


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25 schema:description ObjectiveThis study aimed to compare 18F-fluorodesoxyglucose positron emission tomography/MRI (18F-FDG-PET-MRI) fusion images, including diffusion-weighted imaging (DWI), 18F-FDG-PET/CT, and ultrasound (US) regarding their performance in nodal staging of patients with head and neck squamous cell carcinoma (HNSCC).Materials and methodsEighteen patients prospectively underwent ultrasound examination, 18F-FDG- PET/CT, and MRI before oral tumor resection and bilateral neck dissection. PET data sets were fused with contrast-enhanced T1-weighted MR images. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for nodal detection were calculated for all the imaging modalities. Furthermore, the accuracy of the correct N-staging was calculated for all methods. Detailed histopathology served as the standard of reference.ResultsThe sensitivity, specificity, PPV, NPV, and accuracy for detection of lymph node metastases were 63, 99, 86, 96, and 95 % for ultrasound; 30, 97, 56, 92, and 90 % for 18F-FDG-PET/CT; 52, 96, 59, 94, and 91 % for 18F-FDG-PET-MRI; and 53, 97, 67, 95, and 92 % for 18F-FDG-PET-MRI plus DWI, respectively. There was no significant difference in the diagnostic accuracy for lymph node metastasis detection between 18F-FDG-PET-MRI and 18F-FDG-PET/CT (p = 0.839) and between 18F-FDG-PET-MRI plus DWI and 18F-FDG-PET/CT (p = 0.286), respectively. US was significantly more accurate than 18F-FDG-PET/CT (p = 0.009), whereas no significant difference was seen between 18F-FDG-PET-MRI and US (p = 0.223) or 18F-FDG-PET-MRI plus DWI and US (p = 0.115). The nodal stage was correctly rated by 18F-FDG-PET-MRI in eight patients, 18F-FDG-PET-MRI plus DWI in nine patients, US in 12 patients, and 18F-FDG-PET/CT in five out of 18 patients.ConclusionSoftware-based fusion of 18F-FDG-PET-MRI and 18F-FDG-PET-MRI plus DWI may not increase nodal detection and N-staging performance in patients with oral malignancies compared to US and 18F-FDG-PET/CT.Clinical relevanceSurgical staging of cervical lymph nodes will not be replaced even by advanced imaging modalities in the near future.
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32 schema:keywords CT
33 HNSCC
34 MR images
35 MRI
36 MethodsEighteen patients
37 PET data sets
38 PET-MR images
39 PET-MRI
40 PET/CT
41 ResultsThe sensitivity
42 T1-weighted MR images
43 accuracy
44 advanced imaging modalities
45 bilateral neck dissection
46 carcinoma
47 cell carcinoma
48 cervical lymph
49 cervical lymph nodes
50 contrast-enhanced T1-weighted MR images
51 data sets
52 detailed histopathology
53 detection
54 diagnostic accuracy
55 differences
56 diffusion-weighted imaging
57 dissection
58 examination
59 fusion
60 fusion images
61 future
62 head
63 histopathology
64 images
65 imaging
66 imaging modalities
67 lymph
68 lymph node metastasis
69 lymph node metastasis detection
70 lymph nodes
71 malignancy
72 materials
73 metastasis
74 metastasis detection
75 metastasis of HNSCC
76 method
77 modalities
78 near future
79 neck dissection
80 neck squamous cell carcinoma
81 negative predictive value
82 nodal detection
83 nodal stage
84 nodal staging
85 node metastasis
86 nodes
87 oral malignancies
88 oral tumor resection
89 patients
90 performance
91 positive predictive value
92 predictive value
93 reference
94 resection
95 sensitivity
96 set
97 significant differences
98 specificity
99 squamous cell carcinoma
100 stage
101 staging
102 standard of reference
103 standards
104 study
105 tumor resection
106 ultrasound
107 ultrasound examination
108 values
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