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Comparison of 4 modalities for distant metastasis staging in endemic nasopharyngeal carcinoma
Author(s) -
Chua Melvin Lee Kiang,
Ong Seng Chuan,
Wee Joseph Tien Seng,
Ng David Chee Eng,
Gao Fei,
Tan Terence Wee Kiat,
Fong Kam Weng,
Chua Eu Tiong,
Khoo James Boon Kheng,
Low John Seng Hooi
Publication year - 2009
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20974
Subject(s) - medicine , nasopharyngeal carcinoma , radiology , abdomen , scintigraphy , thorax (insect anatomy) , positron emission tomography , metastasis , ultrasound , fluorodeoxyglucose , nuclear medicine , distant metastasis , radiation therapy , cancer , anatomy
Background. Endemic nasopharyngeal carcinoma (NPC) commonly metastasizes to the lungs, liver, and bones. This study aims to assess the efficacy of 4 distant metastasis staging modalities, namely (1) conventional work‐up comprising chest X‐ray, liver ultrasound, and skeletal scintigraphy, (2) CT of the thorax, abdomen, and skeletal scintigraphy, (3) (18)F‐fluorodeoxyglucose positron emission tomography (FDG‐PET), and (4) integrated FDG‐PET/CT. Methods. Seventy‐eight consecutive patients diagnosed with NPC were enrolled and followed up for a minimum of 6 months to confirm the staging at diagnosis. Results. Six patients (7.7%) had distant metastases at diagnosis. The sensitivities and specificities of conventional work‐up, combined CT and skeletal scintigraphy, FDG‐PET, and FDG‐PET/CT were 33.3%, 66.7%, 83.3%, and 83.3%; and 90.3%, 91.7%, 94.4%, and 97.2%, respectively. The corresponding accuracies were 85.9%, 89.7%, 93.6%, and 96.2%. Conclusions. FDG‐PET/CT is the most sensitive, specific, and accurate modality for distant metastasis staging of endemic NPC. © 2008 Wiley Periodicals, Inc. Head Neck, 2009