title: PET/CT and 3-T whole-body MRI in the detection of malignancy in treated oropharyngeal and hypopharyngeal carcinoma.
abstract: OBJECTIVE
  We performed a prospective comparison of the diagnostic capability of integrated fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (PET/CT), 3-T whole-body magnetic resonance imaging (WB-MRI) and their combination in detecting malignancy in treated oropharyngeal or hypopharyngeal squamous cell carcinoma (OHSCC).
  
  
  METHODS
  Seventy-nine OHSCC patients at a high risk of residual disease or suspected to have recurrence after the completion of chemoradiation were included in the study. All patients underwent PET/CT and WB-MRI within 10 days of each other. Histology and follow-up data were used as the reference standard. The McNemar test was used to compare sensitivity and specificity, while the area under the receiver-operating characteristic curve (AUC) was used for comparison of diagnostic capabilities.
  
  
  RESULTS
  Twenty-nine patients (36.7%) had residual/recurrent tumours or second primary tumours. Overall, there was a trend towards increased sensitivity and diagnostic capability for PET/CT compared with WB-MRI (72.4 vs 55.2%, p = 0.13; 0.826 vs 0.753, p = 0.24, respectively). The diagnostic capability of combined interpretation of PET/CT and WB-MRI was similar to PET/CT alone (0.827 vs 0.826, p = 0.97) but was significantly higher than WB-MRI alone (0.827 vs 0.753, p = 0.04).
  
  
  CONCLUSIONS
  PET/CT showed a trend towards higher diagnostic capability than 3-T WB-MRI in detecting residual/recurrent tumours or second primary tumours in OHSCC. The combined use of PET/CT and WB-MRI provided more added value to WB-MRI alone than to PET/CT alone. Additional PET/CT can be useful in patients with questionable MRI findings of malignancy.
authors.affiliation: Molecular Imaging Center, Chang Gung University, Taoyuan, Taiwan. Shng6@ms25.hinet.net
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
authors.forename: Sheng-Chieh
authors.initials: SC
authors.lastname: Chan
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Chin-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Joseph
authors.initials: J
authors.lastname: Tung-Chieh Chang
authors.forename: Sheung-Fat
authors.initials: SF
authors.lastname: Ko
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Kang-Hsing
authors.initials: KH
authors.lastname: Fan
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D007090:Image Interpretation, Computer-Assisted; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging