[Comparison between PET-CT and MRI in diagnosing nodal metastasis of nasopharyngeal carcinoma].
OBJECTIVE
Nodal metastasis pattern of nasopharyngeal carcinoma (NPC) influences treatment planning. This study was to compare the diagnostic value of integrated positron emission tomography-computed tomography (PET-CT) with that of magnetic resonance imaging (MRI) in detecting nodal metastasis of NPC, and explore the regulation of nodal metastasis of NPC.


METHODS
Clinical data of 105 NPC patients, treated in Cancer Center of Sun Yat-sen University from Jun. 2003 to May 2004, were analyzed. All patients underwent PET-CT and MRI. Findings of PET-CT and MRI were evaluated with the results of follow-up. Distribution of metastatic nodes in different nodal groups was assessed.


RESULTS
Among the 105 patients, nodal metastasis patterns shown on PET-CT and MRI were diverse in 35 patients. Thirty cervical nodes were positive on PET-CT, but negative on MRI; 25 of them were later confirmed positive by follow-up. Thirty-seven cervical nodes were negative on PET-CT, but positive on MRI; 21 of them were confirmed negative by follow-up. Based on the results of follow-up, 77 patients (73.3%) had nodal involvement. Level II nodes were the most frequently involved (87.0%). Along the jugular chain, the frequencies of nodal metastases in level III, level IV, supraclavicular fossa, and level VII were 42.9%, 14.3%, 7.8%, and 1.3%, respectively. The frequency of nodal metastases in retropharyngeal nodes was 70.1%. Cervical nodes involvement without retropharyngeal nodes involvement was seen in 23 patients (29.9%).


CONCLUSIONS
The diagnostic accuracy of PET-CT in detecting nodal metastases of NPC is better than that of MRI. The nodal metastases of NPC reveal a decreasing frequency along the jugular chain. Both retropharyngeal and level II nodes are the first-echelon nodes of NPC.
Hu
Wei-Han
WH
Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China.
Zhang
Guo-Yi
GY
Liu
Li-Zhi
LZ
Wu
Hu-Bing
HB
Li
Li
L
Gao
Yuan-Hong
YH
Pan
Yi
Y
Wang
Quan-Shi
QS
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D049268:Positron-Emission Tomography; D012189:Retrospective Studies