Is PET superior to MRI in the pretherapeutic evaluation of head and neck squamous celi carcinoma?

Year 2007, Volume: 17 Issue: 6, 324 - 328, 24.11.2007

Ahmet Ural Amir Minovi Andreas Hertel Erich Horfmann Wolfgang Draf Ulrike Bockmuehl

Abstract

Objectives: This study was designed to compare the effectiveness of positron emission tomography PET and magnetic resonance imaging MRI in the prethera­ peutic staging of squamous celi carcinoma SCC of the head and neck.Patients and Methods: The study included 34 consecu- tive patients 27 males, 7 females; mean age 61 years; range 42 to 82 years with SCC of the head and neck. Ali thepatientsunderwentwholebody[18Flfluorodeoxyglucose FDG -PET and MRI seans for pretherapeutic evaluation.Diagnoses were confirmed by histopathologic examina- tion of endoscopic biopsy specimens.Results: The sites of the primary tumors were the oro- pharynx n=15, 44% , larynx n=10, 29% , hypopharynx n=8, 24% , and nasopharynx n=1, 3% . Surgery was the treatment of choice in 20 patients 59% , ineluding 23 neck disseetions. Fourteen patients 41% were treated with radiochemotherapy. Both PET and MRI were able to detect the primary tumor in 33 cases 97% . İn two patients 6% , PET was able to detect distant metastases in the lung and iliac bone, ali of which were confirmed by biop- sies. Seven neck specimens 30% showed lymph node metastasis. Sensitivity and specificity rates for deteetion of lymph node metastasis were 100% and 87.5% for PET, and 85.7% and 87.5% for MRI, respeetively.Conclusion: Although PET seems to be superior to MRI in deteeting nodal disease and distant metastases, it is stili early to recommend it as a primary tool for pre­ therapeutic evaluation of head and neck cancers due to its limited availability and higher cost.

Keywords

Carcinoma, squamous cell/radionuclide imaging, head and neck neoplasms, magnetic resonance imaging, neoplasm staging, positron-emission tomography

Baş-boyun bölgesi yassı hücreli karsinomlarm tedavi öncesi değerlendirilmesinde PET MRG'den üstün müdür?

Abstract

Amaç: Bu çalışmada, yassı hücreli baş-boyun karsinomlarının tedavi öncesi değerlendirilmesinde pozitron emisyon tomografisi PET ve manyetik rezonans görüntülemenin MRG etkinliğinin karşılaştırılması amaçlandı.Hastalar ve Yöntemler: Çalışmaya baş-boyun bölgesi yassı hücreli karsinomu olan 34 ardışık hasta alındı. Tüm hastalar tedavi öncesinde tüm vücut [18F]florodeoksiglukoz FDG -PET ve MRG görüntülemesi ile değerlendirildi. Tüm hastaların tanıları endoskopik biyopsi örneklerinin histopatolojik değerlendirilmesi ile doğrulandı.Bulgular: Primer tümörlerin yerleşimleri şöyleydi: orofarenks n=15, %44 , larenks n=10, %29 , hipofarenks n=8, %24 , nazofarenks n=1, %3 . Yirmi hastada %59 cerrahi tedavi uygulandı; bu hastalara 23 boyun diseksiyonu yapıldı. On dört hastada %41 radyoterapi uygulandı. Her iki görüntüleme yöntemi de 33 hastada %97 primer tümörü doğru olarak saptayabildi. Ayrıca, PET yardımıyla iki hastada %6 akciğer ve iliyak kemikte uzak metastazlar saptandı; bunların hepsi biyopsi sonuçlarıyla doğrulandı. Boyun diseksiyonlarının yedisinde %30 lenf nodu metastazı vardı. Lenf nodu tutulumunun gösterilmesinde duyarlılık ve özgüllük oranları PET için sırasıyla %100 ve %87.5, MRG için %85.7 ve %87.5 bulundu.Sonuç: Nodal hastalığın ve uzak metastazların saptanmasında PET MRGʼden daha üstün görünmesine rağmen, bu yöntemi baş-boyun kanserlerinin tedavi öncesi değerlendirilmesinde esas araç olarak önermek sınırlı kullanımı ve yüksek maliyeti nedeniyle erkendir

Keywords

Yası hücreli karsinom/radyonüklid görüntüleme, baş-boyun tümörleri, manyetik rezonans görüntüleme, tümör evrelemesi, pozitron emisyon tomografisi

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