title: Value of retrospective image fusion of ¹⁸F-FDG PET and MRI for preoperative staging of head and neck cancer: comparison with PET/CT and contrast-enhanced neck MRI.
abstract: OBJECTIVE
  To assess the clinical value of retrospective image fusion of neck MRI and (18)F-fluorodeoxyglucose ((18)F-FDG) PET for locoregional extension and nodal staging of neck cancer.
  
  
  METHODS
  Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated.
  
  
  RESULTS
  Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p=0.041 and p=0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p=0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p=0.0026) and accuracy (p=0.041) were significant.
  
  
  CONCLUSIONS
  Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer.
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Radiology, Hyogo Cancer Center, Hyogo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Kanda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitajima
authors.forename: Yuko
authors.initials: Y
authors.lastname: Suenaga
authors.forename: Jyunya
authors.initials: J
authors.lastname: Konishi
authors.forename: Ryohei
authors.initials: R
authors.lastname: Sasaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Morimoto
authors.forename: Miki
authors.initials: M
authors.lastname: Saito
authors.forename: Naoki
authors.initials: N
authors.lastname: Otsuki
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Nibu
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Fused imaging; Head and neck cancer; MRI; PET/CT; Staging