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Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

An Erratum to this article was published on 13 February 2009

Abstract

Purpose

We prospectively compared PET/CT and conventional imaging for initial staging of nasopharyngeal carcinoma (NPC).

Methods

A 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.

Results

With 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%).

Conclusion

In 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.

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Acknowledgements

We gratefully acknowledge the grants from the National Science Council of Taiwan (NSC 95-2314-B-182A-135-MY2 and NSC 96-2314-B-182A-120).

Author information

Authors and Affiliations

  1. Molecular Imaging Center and Department of Diagnostic Radiology, Chang Gung Memorial Hospital Linkou Medical Center, Kueishan, Taiwan

    Shu-Hang Ng, Sheung-Fat Ko & Shu-Chyn Chin

  2. Department of Nuclear Medicine, Chang Gung Memorial Hospital Linkou Medical Center, Kueishan, Taiwan

    Sheng-Chieh Chan, Tzu-Chen Yen & Feng-Yuan Liu

  3. Department of Radiation Oncology, Chang Gung Memorial Hospital Linkou Medical Center, Kueishan, Taiwan

    Joseph Tung-Chieh Chang & Kang-Hsing Fan

  4. Department of Otorhinolaryngology, Chang Gung Memorial Hospital Linkou Medical Center, Kueishan, Taiwan

    Chun-Ta Liao

  5. Department of Medical Oncology, Chang Gung Memorial Hospital Linkou Medical Center, Kueishan, Taiwan

    Cheng-Lung Hsu

  6. Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fu-Shin Street, Kueishan, Taoyuan, 333, Taiwan

    Shu-Hang Ng

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  1. Shu-Hang Ng
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Correspondence to Shu-Hang Ng.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00259-009-1080-6

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Ng, SH., Chan, SC., Yen, TC. et al. Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up. Eur J Nucl Med Mol Imaging 36, 12–22 (2009). https://doi.org/10.1007/s00259-008-0918-7

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  • DOI: https://doi.org/10.1007/s00259-008-0918-7

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