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Published online before print August 18, 2008, 10.1148/radiol.2491071753
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(Radiology 2008;249:203-211.)
© RSNA, 2008

Head and Neck Imaging

Detection and Restaging of Residual and/or Recurrent Nasopharyngeal Carcinoma after Chemotherapy and Radiation Therapy: Comparison of MR Imaging and FDG PET/CT1

Maurizio Comoretto, MD, Luca Balestreri, MD, Eugenio Borsatti, MD, Marino Cimitan, MD, Giovanni Franchin, MD, and Mauro Lise

1 From the Department of Radiology (M. Comoretto, L.B.), Department of Nuclear Medicine (E.B., M. Cimitan), Division of Radiotherapy (G.F.), and Epidemiology Unit (M.L.), Centro di Riferimento Oncologico-IRCCS, Via F Gallini, 2, 33081 Aviano (PN), Italy. Received October 4, 2007; revision requested January 4, 2008; revision received January 24; accepted March 19; final version accepted April 29. Address correspondence to M.C. (e-mail: mcomoretto{at}cro.it).

Purpose: To compare the accuracy of magnetic resonance (MR) imaging and combined fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), alone and in combination, in detection and restaging treated nasopharyngeal carcinoma (NPC).

Materials and Methods: This retrospective study was performed after institutional review board approval and informed consent were obtained. Sixty-three consecutive patients treated for NPC underwent follow-up with both MR imaging and FDG PET/CT. Findings were evaluated according to the TNM classification. Final diagnosis was confirmed at biopsy or imaging follow-up for at least 6 months. Proportions and their 95% confidence intervals were computed; for comparison of data obtained separately from MR imaging and FDG PET/CT and those obtained from their combined use, the McNemar test was used. P < .05 was considered to indicate a statistically significant difference.

Results: There was a trend toward greater overall accuracy of MR over PET/CT in detecting residual and/or recurrent NPC at the primary site; 92.1% (58 of 63 patients) for MR versus 85.7% (54 of 63) for FDG PET/CT (P = .16). Overall accuracy for tumor restaging was 74.6% (47 of 63) for MR and 73.0% (46 of 63) for FDG PET/CT (either modality used alone), but the overall combined accuracy was 92.1% (58 of 63) (all P values < .01).

Conclusion: MR imaging demonstrated a trend toward higher accuracy than did FDG PET/CT in detecting residual and/or recurrent NPC at the primary tumor site. The combined use of MR and FDG PET/CT was more accurate for tumor restaging than when either modality was used independently.

© RSNA, 2008