Clinical Usefulness of Fused PET/CT Compared with PET Alone or CT Alone in Nasopharyngeal Carcinoma Patients

• Published in: Anticancer research Vol. 26; no. 2B; pp. 1471 - 1477
• Main Authors: CHEN, Yen-Kung, SU, Chen-Tau, DING, Hueisch-Jy, CHI, Kwan-Hwa, HANG, Ji-An, SHEN, Yeh-You, CHEN, Liang-Kung, YEH, Chia-Lu, LIAO, Alfred C, KAO, Chia-Hung
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-03-2006
• Subjects: Biological and medical sciences; Female; Fluorodeoxyglucose F18; Humans; Male; Medical sciences; Middle Aged; Nasopharyngeal Neoplasms - diagnostic imaging; Nasopharyngeal Neoplasms - pathology; Neoplasm Staging; Otorhinolaryngology. Stomatology; Positron-Emission Tomography - methods; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Radionuclide study; Human; computed tomography; 2-deoxy-2-fluoroglucose; nasopharyngeal carcinoma; Radiodiagnosis; Nasopharynx cancer; Malignant tumor; Nasopharynx carcinoma; Cancerology; PET/CT; Medical imagery; ENT disease; 18F-fluorodeoxyglucose; Pharynx disease; Computerized axial tomography; Diagnosis; Positron emission tomography; Comparative study; Emission tomography
• ISSN: 0250-7005; 1791-7530

The diagnostic accuracy of fused positron emission tomography/computed tomography (PET/CT) was compared with CT alone and
PET alone in the staging and re-staging of nasopharyngeal carcinoma (NPC) patients. Patients and Methods: Eighty-six fluorine-18-2-fluoro-2-deoxy-D-glucose
(FDG) PET/CT studies were retrospectively performed in 70 patients with NPC, 20 patients for primary tumor staging and 50
patients for re-staging after treatment. Each lesion was analyzed visually and assigned a score on a 5-point scale. Each study
was interpreted in 3 ways: PET images were evaluated in the absence of CT data, CT images in the absence of PET data and fused
PET/CT images. The results of these images were correlated with histological findings, as well as long-term radiological and
clinical follow-up (the shortest follow-up period after imaging was 6 months). PET, CT and PET/CT accuracy were compared by
a McNemar test. Results: Fused PET/CT correctly characterized the tumor-node-metastasis system stage in 82 out of 86 studies
(95.4%; 95% CI: 90.9% to 99.9%). PET alone and CT alone were found to be accurate in 71 out of 86 studies (82.6%; 95% CI:
74.5% to 90.6%) and 63 out of 86 studies (73.3%; 95% CI: 63.9% to 82.6%), respectively. Furthermore, the differences between
PET/CT and either PET alone or CT alone were statistically significant (p<0.05). Overall, the study-based analysis of PET/CT
for staging NPC demonstrated 48 true-positive, 2 false-negative, 34 true-negative and 2 false-positive studies. The sensitivity,
specificity, accuracy, positive predictive value and negative predictive value of FDG-PET/CT studies for staging NPC were
96%, 94.4%, 95.4%, 96% and 94.4%, respectively. Conclusion: PET/CT is more accurate than PET alone or CT alone for the depiction
of NPC. Fused PET/CT is a valuable imaging tool in patients for staging diagnosis of NPC.