title: ¹⁸F-FDG PET/CT and 3.0-T whole-body MRI for the detection of distant metastases and second primary tumours in patients with untreated oropharyngeal/hypopharyngeal carcinoma: a comparative study.
abstract: OBJECTIVE
  The aim of this prospective study was to compare the diagnostic value of (18)F-FDG PET/CT and 3.0-T whole-body MRI (WB-MRI) for the assessment of distant metastases and second primary cancer (SPC) in patients with untreated oropharyngeal or hypopharyngeal squamous cell carcinoma (OHSCC).
  
  
  METHODS
  A total of 103 patients were enrolled. All participants underwent 3.0-T WB-MRI and (18)F-FDG PET/CT. The diagnostic capabilities of the two imaging modalities were compared using the area under the receiver-operating-characteristic curve. Histology and follow-up data were used as the reference standard.
  
  
  RESULTS
  Of the 103 patients, 18 (17.5%) were found to have either distant metastases or SPC. A total of 21 sites were involved. On a lesion-based analysis, (18)F-FDG PET/CT showed a trend toward a higher sensitivity than WB-MRI (81.0% vs. 61.9%, P = 0.125). The area under the curve (AUC) for PET/CT was also higher than for WB-MRI, although not significantly so (0.932 vs. 0.866, P = 0.189). On a patient-based analysis, the sensitivity of WB-MRI was lower than that of PET/CT (66.7% vs. 83.3%, P = 0.625). In terms of diagnostic capability, the AUC was higher for PET/CT than WB-MRI (0.886 vs. 0.813, P = 0.355). The maximal SUV of the regional lymph nodes (SUVn) above the median value (8.7 g/ml) was significantly associated with the occurrence of distant metastasis (P = 0.026).
  
  
  CONCLUSIONS
  (18)F-FDG PET/CT showed a consistent trend toward higher sensitivity and diagnostic capability than 3.0-Tesla WB-MRI for the detection of distant metastases and SPCs in patients with untreated OHSCC. Our data also suggest that SUVn assessed by PET/CT can provide additional information for the prediction of distant metastases.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
authors.forename: Sheng-Chieh
authors.initials: SC
authors.lastname: Chan
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Shy-Chyi
authors.initials: SC
authors.lastname: Chin
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Yau-Yau
authors.initials: YY
authors.lastname: Wai
authors.forename: Jiun-Jie
authors.initials: JJ
authors.lastname: Wang
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
mesh_terms: D001692:Biological Transport; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
chemical_list: D019788:Fluorodeoxyglucose F18