Usefulness of Integrated PET/MRI in Head and Neck Cancer: A Preliminary Study View Full Text


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Article Info

DATE

2013-12-06

AUTHORS

Soo Jin Lee, Hyo Jung Seo, Gi Jeong Cheon, Ji Hoon Kim, E. Edmund Kim, Keon Wook Kang, Jin Chul Paeng, June-Key Chung, Dong Soo Lee

ABSTRACT

PurposeThe new modality of an integrated positron emission tomography/magnetic resonance imaging (PET/MRI) has recently been introduced but not validated. Our objective was to evaluate clinical performance of 18F-fluoro-2-deoxyglucose (18F-FDG) PET/MRI in patients with head and neck cancer.MethodsThis retrospective study was conducted between January 2013 and February 2013. Ten patients (eight men, two women; mean age, 61.4 ± 13.4 years) with histologically proven head and neck tumors were enrolled. Whole-body PET/MRI and regional positron emission tomography (PET) with dedicated MRI were sequentially obtained. Maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume, total lesion glycolysis and contrast enhancement were analyzed. A total of ten whole-body positron emission tomography (PET), ten regional positron emission tomography (PET), ten dedicated MRI and ten regional PET/gadolinium-enhanced T1-weighted (Gd)-MRI images were analyzed for initial staging. Two nuclear medicine physicians analyzed positron emission tomography (PET) and PET/MRI with a consensus. One radiologist analyzed dedicated MRI. The primary lesions and number of metastatic lymph nodes analyzed from each image were compared.ResultsEight patients were diagnosed with head and neck cancer (one tongue cancer, four tonsillar cancers, one nasopharyngeal cancer and two hypopharyngeal cancers) by histological diagnosis. Two benign tumors (pleomorphic adenoma and Warthin tumor) were diagnosed with surgical operation. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) attenuated by MRI showed good image quality for the lesion detection. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) detected ten primary sites and compensated for a missed lesion on dedicated MRI. A discordant number of suspicious lymph node metastases was noted according to the different images; 22, 16, 39 and 40 in the whole-body positron emission tomography (PET) only, dedicated MR, regional positron emission tomography (PET) only and regional PET/Gd-MRI, respectively. There was no distant metastasis based on analysis of whole-body positron emission tomography (PET) and whole-body PET/Dixon-volume interpolated breathhold examination (VIBE) MRI. Regional PET/Gd-MRI combined with whole-body PET/MRI modified staging in three patients. Lesions of primary tumor and suspicious metastasis were well detected on both value of SUVmax and visual analysis. The regional PET/Gd-MRI combined with whole-body PET/MRI showed convenient clinical staging performance compared with positron emission tomography (PET) and MRI alone.ConclusionIn this preliminary study, PET attenuated by MRI showed good image quality to detect lesions. And whole-body PET/MRI as a single modality was feasible for staging in a clinical setting. Whole-body positron emission tomography (PET), regional positron emission tomography (PET), dedicated MRI and regional PET/Gd-MRI showed discordant results in lesion detection. These discordant results might be synergistic effect for accurate staging. More... »

PAGES

98-105

References to SciGraph publications

  • 2004-01-14. FDG-PET delayed imaging for the detection of head and neck cancer recurrence after radio-chemotherapy: comparison with MRI/CT in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2011-07-08. Diagnosis and dosimetry in differentiated thyroid carcinoma using 124I PET: comparison of PET/MRI vs PET/CT of the neck in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
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  • 2011-04-05. Whole-body hybrid PET/MRI: ready for clinical use? in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2012-09-28. PET/MRI in head and neck cancer: initial experience in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2008-10-07. Morphological MRI criteria improve the detection of lymph node metastases in head and neck squamous cell carcinoma: multivariate logistic regression analysis of MRI features of cervical lymph nodes in EUROPEAN RADIOLOGY
  • 2008-10-09. CT, MR, US, 18F-FDG PET/CT, and their combined use for the assessment of cervical lymph node metastases in squamous cell carcinoma of the head and neck in EUROPEAN RADIOLOGY
  • 2002-05-04. Detection of unknown primary tumours and distant metastases in patients with cervical metastases: value of FDG-PET versus conventional modalities in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2012-08-28. Diagnostic value of combined 18F-FDG PET/MRI for staging and restaging in paediatric oncology in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
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    16 schema:description PurposeThe new modality of an integrated positron emission tomography/magnetic resonance imaging (PET/MRI) has recently been introduced but not validated. Our objective was to evaluate clinical performance of 18F-fluoro-2-deoxyglucose (18F-FDG) PET/MRI in patients with head and neck cancer.MethodsThis retrospective study was conducted between January 2013 and February 2013. Ten patients (eight men, two women; mean age, 61.4 ± 13.4 years) with histologically proven head and neck tumors were enrolled. Whole-body PET/MRI and regional positron emission tomography (PET) with dedicated MRI were sequentially obtained. Maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume, total lesion glycolysis and contrast enhancement were analyzed. A total of ten whole-body positron emission tomography (PET), ten regional positron emission tomography (PET), ten dedicated MRI and ten regional PET/gadolinium-enhanced T1-weighted (Gd)-MRI images were analyzed for initial staging. Two nuclear medicine physicians analyzed positron emission tomography (PET) and PET/MRI with a consensus. One radiologist analyzed dedicated MRI. The primary lesions and number of metastatic lymph nodes analyzed from each image were compared.ResultsEight patients were diagnosed with head and neck cancer (one tongue cancer, four tonsillar cancers, one nasopharyngeal cancer and two hypopharyngeal cancers) by histological diagnosis. Two benign tumors (pleomorphic adenoma and Warthin tumor) were diagnosed with surgical operation. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) attenuated by MRI showed good image quality for the lesion detection. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) detected ten primary sites and compensated for a missed lesion on dedicated MRI. A discordant number of suspicious lymph node metastases was noted according to the different images; 22, 16, 39 and 40 in the whole-body positron emission tomography (PET) only, dedicated MR, regional positron emission tomography (PET) only and regional PET/Gd-MRI, respectively. There was no distant metastasis based on analysis of whole-body positron emission tomography (PET) and whole-body PET/Dixon-volume interpolated breathhold examination (VIBE) MRI. Regional PET/Gd-MRI combined with whole-body PET/MRI modified staging in three patients. Lesions of primary tumor and suspicious metastasis were well detected on both value of SUVmax and visual analysis. The regional PET/Gd-MRI combined with whole-body PET/MRI showed convenient clinical staging performance compared with positron emission tomography (PET) and MRI alone.ConclusionIn this preliminary study, PET attenuated by MRI showed good image quality to detect lesions. And whole-body PET/MRI as a single modality was feasible for staging in a clinical setting. Whole-body positron emission tomography (PET), regional positron emission tomography (PET), dedicated MRI and regional PET/Gd-MRI showed discordant results in lesion detection. These discordant results might be synergistic effect for accurate staging.
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    22 schema:keywords ConclusionIn
    23 Gd-MRI
    24 MR
    25 MRI
    26 MRI images
    27 MethodsThis retrospective study
    28 PET/MRI
    29 ResultsEight patients
    30 SUVmax
    31 accurate staging
    32 analysis
    33 benign tumors
    34 better image quality
    35 cancer
    36 clinical performance
    37 clinical setting
    38 consensus
    39 contrast enhancement
    40 dedicated MR
    41 dedicated MRI
    42 detection
    43 diagnosis
    44 different images
    45 discordant number
    46 discordant results
    47 distant metastasis
    48 effect
    49 emission tomography
    50 enhancement
    51 glycolysis
    52 head
    53 histological diagnosis
    54 image quality
    55 images
    56 imaging
    57 initial staging
    58 integrated PET/MRI
    59 lesion detection
    60 lesion glycolysis
    61 lesions
    62 lymph node metastasis
    63 lymph nodes
    64 magnetic resonance imaging
    65 maximum standardized uptake value
    66 medicine physicians
    67 metabolic tumor volume
    68 metastasis
    69 metastatic lymph nodes
    70 missed lesions
    71 modalities
    72 neck cancer
    73 neck tumors
    74 new modality
    75 node metastasis
    76 nodes
    77 nuclear medicine physicians
    78 number
    79 objective
    80 operation
    81 patients
    82 performance
    83 physicians
    84 positron emission tomography
    85 positron emission tomography/magnetic resonance imaging
    86 preliminary study
    87 primary lesion
    88 primary site
    89 primary tumor
    90 quality
    91 radiologists
    92 resonance imaging
    93 results
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    95 setting
    96 single modality
    97 sites
    98 staging
    99 standardized uptake value
    100 study
    101 surgical operation
    102 suspicious lymph node metastasis
    103 suspicious metastasis
    104 synergistic effect
    105 tomography
    106 tomography/magnetic resonance imaging
    107 total
    108 total lesion glycolysis
    109 tumor volume
    110 tumors
    111 uptake value
    112 usefulness
    113 value of SUVmax
    114 values
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    119 schema:name Usefulness of Integrated PET/MRI in Head and Neck Cancer: A Preliminary Study
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