Diagnostic performance of 18 fluorodesoxyglucose positron emission/computed tomography and magnetic resonance imaging in detecting T1-T2 head and neck squamous cell carcinoma

Anne Chaput; Philippe Robin; Fabien Podeur; Morgan Ollivier; Nathalie Keromnes; Valentin Tissot; Michel Nonent; Pierre-Yves Salaün; Jean Rousset; Ronan Abgral

doi:10.1002/lary.26729

Diagnostic performance of ¹⁸ fluorodesoxyglucose positron emission/computed tomography and magnetic resonance imaging in detecting T1-T2 head and neck squamous cell carcinoma

Laryngoscope. 2018 Feb;128(2):378-385. doi: 10.1002/lary.26729. Epub 2017 Jun 10.

Authors

Anne Chaput¹, Philippe Robin^{1

2}, Fabien Podeur³, Morgan Ollivier³, Nathalie Keromnes¹, Valentin Tissot³, Michel Nonent³, Pierre-Yves Salaün^{1

2}, Jean Rousset^{3

4}, Ronan Abgral^{1

2}

Affiliations

¹ Department of Nuclear Medicine, University Hospital of Brest, Brest, France.
² Thrombosis Study Group in Western Brittany, Research's Federative Institute 148, European University of Brittany, Brest, France.
³ Department of Radiology, University Hospital of Brest, Brest, France.
⁴ Department of Radiology, Military Hospital of Brest, Brest, France.

PMID: 28600822
DOI: 10.1002/lary.26729

Abstract

Objectives/hypothesis: The aim of this study was to assess and compare the diagnostic accuracy of ¹⁸ fluorodesoxyglucose positron emission/computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI) to detect T1-T2 head and neck squamous cell carcinoma (HNSCC).

Study design: Prospective case series.

Methods: Thirty-five consecutive patients with histologically proven T1-T2 HNSCC were prospectively included. All patients underwent pretherapeutic FDG-PET/CT and MRI. Two nuclear medicine physicians and 2 radiologists blindly reviewed all FDG-PET/CT and MRI, respectively. A five-point qualitative scale was used to estimate tumor detection ability. Sensitivity of each modality was compared together using a McNemar test. Interobserver variability was assessed by kappa index (κ) of Cohen statistics. Maximal standardized uptake value (SUV_MAX ), metabolic tumor volume (MTV) in FDG-PET/CT, and gadolinium enhancement (%GE) in MRI of each tumor were recorded and compared with T stage using a Mann-Whitney test. Tumor-to-normal tissue ratios in FDG-PET/CT and MRI (TNR_PET and TNR_MRI ) were calculated and compared together using a Student t test.

Results: Among the 35 primary tumors, 29 were detected by FDG-PET/CT and 22 by MRI. MRI detected none of the six lesions incorrectly identified by FDG-PET/CT. FDG-PET/CT correctly identified seven of the 13 MRI false-negative results. Sensitivity of FDG-PET/CT to detect T1-T2 HNSCC was significantly higher than MRI (83% vs. 63%, P = .015). T stage was significantly correlated with MTV (P = .002) unlike with SUV_MAX (P = .06) and %GE (P = .70). TNR_PET was significantly higher than TNR_MRI (3.5 ± 3.2 vs. 1.2 ± 0.3, P < .0001).

Conclusions: Our study showed a higher diagnostic accuracy of FDG-PET/CT than MRI to detect T1-T2 HNSCC with a good interobserver agreement.

Level of evidence: 4. Laryngoscope, 128:378-385, 2018.

Keywords: 18F-fluorodeoxyglucose; Head and neck squamous cell carcinoma; T1-T2 stage; magnetic resonance imaging; positron emission tomography.

MeSH terms

Aged
Carcinoma, Squamous Cell / diagnostic imaging*
Carcinoma, Squamous Cell / pathology
False Negative Reactions
Female
Fluorodeoxyglucose F18*
Head and Neck Neoplasms / diagnostic imaging*
Head and Neck Neoplasms / pathology
Humans
Magnetic Resonance Imaging / methods
Magnetic Resonance Imaging / statistics & numerical data*
Male
Middle Aged
Observer Variation
Positron Emission Tomography Computed Tomography / methods
Positron Emission Tomography Computed Tomography / statistics & numerical data*
Predictive Value of Tests
Prospective Studies
Radiopharmaceuticals*
Reproducibility of Results
Sensitivity and Specificity
Squamous Cell Carcinoma of Head and Neck
Tumor Burden

Substances

Radiopharmaceuticals
Fluorodeoxyglucose F18