Comparing diagnostic performance of PET/CT, MRI, and CT in characterization of cN0 head and neck squamous cell carcinoma: A multicenter study

IF 2.5 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiography Pub Date : 2025-02-26 DOI:10.1016/j.radi.2025.102902

S. Mohammadzadeh , A. Mohebbi , Z. Moradi , A.A. Ardakani , A. Mohammadi , S.M. Tavangar

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引用次数: 0

Abstract

Introduction

Assessing local invasion is essential for determining stage of cN0 head and neck squamous cell carcinoma (HNSCC). We aimed to evaluate the performance of fluorine-18 fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) in HNSCC characterization and compare it with conventional imaging.

Methods

This multicentral study included 278 consecutive newly diagnosed cN0 HNSCC patients recruited from ACRIN 6685 (American College of Radiology Imaging Network) dataset. Four board-certified nuclear radiologists interpreted preoperative PET/CT, MRI, and CT examinations of patients. Imaging results were compared to pathological reference tests through area under curve (AUC), sensitivity, specificity, and receiver operating characteristic (ROC) curve using Stata 18 and Medcalc 22.017.

Results

PET/CT demonstrated 23.5 %, 24.7 %, and 51.6 % upstaging, downstaging, and same staging in T staging of patients in comparison to histopathological evaluation, respectively. When evaluating N status, PET/CT showed 25.7 % upstaging, 20.3 % downstaging, and 53.9 % same staging. An optimal SUV_max cut-off value of 10.9 was determined to predict early-stage (T1, T2) and advanced-stage (T3, T4) HNSCC tumors with an AUC of 0.709 (95 % CI = 0.648–0.766). This cut-off value also predicted N0 and N+ patients with an AUC of 0.670 (95 % CI = 0.606–0.729). Sensitivity and specificity of PET/CT, MRI, and CT for bone invasion, muscle invasion, nerve invasion, cartilage invasion, superficial tissue invasion, overall invasion, and fixed vocal cord were calculated.

Conclusion

Our findings support the valuable accuracy of 18F-FDG PET/CT in staging HNSCC patients. Also, 18F-FDG PET/CT outperformed conventional imaging in characterization of HNSCC tumors.

Implications for practice

By offering an in-depth investigation in imaging of HNSCC tumors, this study contributes to evidence-based clinical decision-making.

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导言：评估局部浸润对于确定头颈部鳞状细胞癌（HNSCC）的cN0分期至关重要。我们的目的是评估氟-18 氟脱氧葡萄糖正电子发射断层扫描/CT（18F-FDG PET/CT）在 HNSCC 特征描述中的性能，并将其与常规成像进行比较。方法这项多中心研究包括从 ACRIN 6685（美国放射学会成像网络）数据集中招募的 278 例连续的新诊断 cN0 HNSCC 患者。四名获得认证的核放射医师对患者的术前 PET/CT、MRI 和 CT 检查进行了解读。使用Stata 18和Medcalc 22.017，通过曲线下面积（AUC）、灵敏度、特异性和接收器操作特征曲线（ROC）将成像结果与病理参考检测结果进行比较。结果与组织病理学评估相比，PET/CT在患者T分期中分别显示出23.5%、24.7%和51.6%的上分期、下分期和相同分期。在评估N状态时，PET/CT显示25.7%的患者分期上升，20.3%的患者分期下降，53.9%的患者分期不变。最佳SUVmax临界值为10.9，可预测早期（T1、T2）和晚期（T3、T4）HNSCC肿瘤，AUC为0.709（95% CI = 0.648-0.766）。该临界值还能预测 N0 和 N+ 患者，AUC 为 0.670（95 % CI = 0.606-0.729）。计算了 PET/CT、MRI 和 CT 对骨侵犯、肌肉侵犯、神经侵犯、软骨侵犯、表层组织侵犯、整体侵犯和固定声带的敏感性和特异性。本研究通过对 HNSCC 肿瘤成像的深入研究，为循证临床决策做出了贡献。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.70

自引率

34.60%

发文量

169

审稿时长

63 days

期刊介绍： Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.