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Diagnostic performance of 18 fluorodesoxyglucose positron emission/computed tomography and magnetic resonance imaging in detecting T1‐T2 head and neck squamous cell carcinoma
Author(s) -
Chaput Anne,
Robin Philippe,
Podeur Fabien,
Ollivier Morgan,
Keromnes Nathalie,
Tissot Valentin,
nt Michel,
Salaün PierreYves,
Rousset Jean,
Abgral Ronan
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26729
Subject(s) - positron emission tomography , magnetic resonance imaging , positron emission , head and neck , nuclear medicine , head and neck squamous cell carcinoma , nuclear magnetic resonance , positron , computed tomography , physics , medicine , head and neck cancer , radiology , electron , nuclear physics , radiation therapy , surgery
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