title: Comparison of SPECT/CT, MRI and CT in diagnosis of skull base bone invasion in nasopharyngeal carcinoma.
abstract: Early detection of skull base invasion in nasopharyngeal carcinoma (NPC) is crucial for correct staging, assessing treatment response and contouring the tumor target in radiotherapy planning, as well as improving the patient's prognosis. To compare the diagnostic efficacy of single photon emission computed tomography/computed tomography (SPECT/CT) imaging, magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of skull base invasion in NPC. Sixty untreated patients with histologically proven NPC underwent SPECT/CT imaging, contrast-enhanced MRI and CT. Of the 60 patients, 30 had skull base invasion confirmed by the final results of contrast-enhanced MRI, CT and six-month follow-up imaging (MRI and CT). The diagnostic efficacy of the three imaging modalities in detecting skull base invasion was evaluated. The rates of positive findings of skull base invasion for SPECT/CT, MRI and CT were 53.3%, 48.3% and 33.3%, respectively. The sensitivity, specificity and accuracy were 93.3%, 86.7% and 90.0% for SPECT/CT fusion imaging, 96.7%, 100.0% and 98.3% for contrast-enhanced MRI, and 66.7%, 100.0% and 83.3% for contrast-enhanced CT. MRI showed the best performance for the diagnosis of skull base invasion in nasopharyngeal carcinoma, followed closely by SPECT/CT. SPECT/CT had poorer specificity than that of both MRI and CT, while CT had the lowest sensitivity.
authors.affiliation: Radiotherapy Center, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Shu-xu
authors.initials: SX
authors.lastname: Zhang
authors.forename: Peng-hui
authors.initials: PH
authors.lastname: Han
authors.forename: Guo-qian
authors.initials: GQ
authors.lastname: Zhang
authors.forename: Rui-hao
authors.initials: RH
authors.lastname: Wang
authors.forename: Yong-bin
authors.initials: YB
authors.lastname: Ge
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Ren
authors.forename: Jian-sheng
authors.initials: JS
authors.lastname: Li
authors.forename: Wen-hai
authors.initials: WH
authors.lastname: Fu
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002277:Carcinoma; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D009361:Neoplasm Invasiveness; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012886:Skull / Q000000981:diagnostic imaging* / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
keywords: computerized tomography; magnetic resonance imaging (MRI); nasopharyngeal carcinoma (NPC); single photon emission computed tomography; skull base invasion