{"title":"鼻咽癌颅底骨侵犯的强化检测:18氟-氟化钠(18F-NaF)正电子发射断层扫描/计算机断层扫描(PET/CT)联合磁共振成像(MRI)的辅助诊断价值。","authors":"Meina Liang, Xufeng Guo, Chengmao Guo, Jingxing Xiao","doi":"10.21037/qims-24-265","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nasopharyngeal carcinoma (NPC) originates in the nasopharyngeal mucosa, the lateral wall of the nasopharynx. A significant challenge in NPC management is skull-base bone invasion (SBBI), which affects prognosis and treatment planning. Magnetic resonance imaging (MRI) is the primary diagnostic tool for SBBI in NPC patients; however, the detection of SBBI can be challenging due to skull-base complexity and overlapping MRI signals. <sup>18</sup>fluorine-sodium fluoride (<sup>18</sup>F-NaF) positron emission tomography/computed tomography (PET/CT) is an emerging imaging technique that has shown promise in detecting osseous lesions. This cohort study aimed to assess the supplementary diagnostic value of <sup>18</sup>F-NaF PET/CT in detecting SBBI in NPC patients compared to that of MRI alone.</p><p><strong>Methods: </strong>Imaging data were retrospectively collected from <sup>18</sup>F-NaF PET/CT and head-and-neck MRI examinations conducted within a 7-day period. The sensitivity, specificity, and accuracy of <sup>18</sup>F-NaF PET/CT, MRI, and the combination of both modalities in detecting SBBI were individually assessed. Both lesion- and patient-based analyses were employed for the comparison. Cochran's Q test was used to compare the accuracy of these methods, while the Bonferroni-corrected McNemar test was used for the pairwise comparisons. The data analysis was performed using the R software package, and a significance level of P<i><</i>0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 164 patients were enrolled in the study. Using <sup>18</sup>F-NaF PET/CT, MRI, and the combined modality of <sup>18</sup>F-NaF PET/CT with MRI, 97, 84, and 94 cases of SBBI were diagnosed, respectively. At the patient level, the diagnostic efficacy (sensitivity, specificity, and accuracy) was as follows: <sup>18</sup>F-NaF PET/CT had 100% sensitivity, 93.1% specificity, and 97.0% accuracy; MRI had 90.2% sensitivity, 98.6% specificity, and 93.9% accuracy; and the combination of <sup>18</sup>F-NaF PET/CT and MRI had 100% sensitivity, 97.2% specificity, and 98.8% accuracy. The accuracy rate of <sup>18</sup>F-NaF PET/CT combined with MRI were significantly higher than that of MRI alone (P<i>=</i>0.034). A total of 284, 243, and 276 SBBI lesions were diagnosed using <sup>18</sup>F-NaF PET/CT, MRI, and <sup>18</sup>F-NaF PET/CT combined with MRI, respectively. The diagnostic efficacy (sensitivity, specificity, and accuracy) at the lesion level was as follows: <sup>18</sup>F-NaF PET/CT had 99.6% sensitivity, 75.9% specificity, and 95.4% accuracy; MRI had 88.2% sensitivity, 93.1% specificity, and 89.1% accuracy; and the combination of <sup>18</sup>F-NaF PET/CT with MRI had 100% sensitivity, 91.4% specificity, and 98.5% accuracy. The combination of <sup>18</sup>F-NaF PET/CT with MRI significantly improved the accuracy rate compared to that of MRI alone, and the difference was statistically significant (P<0.001).</p><p><strong>Conclusions: </strong>The combined use of <sup>18</sup>F-NaF PET/CT and MRI significantly enhanced the diagnosis of SBBI in NPC patients, and the combined method had improved diagnostic sensitivity and accuracy than MRI alone.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485363/pdf/","citationCount":"0","resultStr":"{\"title\":\"Enhanced detection of skull-base bone invasion in nasopharyngeal carcinoma: the supplementary diagnostic value of <sup>18</sup>fluorine-sodium fluoride (<sup>18</sup>F-NaF) positron emission tomography/computed tomography (PET/CT) combined with magnetic resonance imaging (MRI).\",\"authors\":\"Meina Liang, Xufeng Guo, Chengmao Guo, Jingxing Xiao\",\"doi\":\"10.21037/qims-24-265\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Nasopharyngeal carcinoma (NPC) originates in the nasopharyngeal mucosa, the lateral wall of the nasopharynx. A significant challenge in NPC management is skull-base bone invasion (SBBI), which affects prognosis and treatment planning. Magnetic resonance imaging (MRI) is the primary diagnostic tool for SBBI in NPC patients; however, the detection of SBBI can be challenging due to skull-base complexity and overlapping MRI signals. <sup>18</sup>fluorine-sodium fluoride (<sup>18</sup>F-NaF) positron emission tomography/computed tomography (PET/CT) is an emerging imaging technique that has shown promise in detecting osseous lesions. This cohort study aimed to assess the supplementary diagnostic value of <sup>18</sup>F-NaF PET/CT in detecting SBBI in NPC patients compared to that of MRI alone.</p><p><strong>Methods: </strong>Imaging data were retrospectively collected from <sup>18</sup>F-NaF PET/CT and head-and-neck MRI examinations conducted within a 7-day period. The sensitivity, specificity, and accuracy of <sup>18</sup>F-NaF PET/CT, MRI, and the combination of both modalities in detecting SBBI were individually assessed. Both lesion- and patient-based analyses were employed for the comparison. Cochran's Q test was used to compare the accuracy of these methods, while the Bonferroni-corrected McNemar test was used for the pairwise comparisons. The data analysis was performed using the R software package, and a significance level of P<i><</i>0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 164 patients were enrolled in the study. Using <sup>18</sup>F-NaF PET/CT, MRI, and the combined modality of <sup>18</sup>F-NaF PET/CT with MRI, 97, 84, and 94 cases of SBBI were diagnosed, respectively. At the patient level, the diagnostic efficacy (sensitivity, specificity, and accuracy) was as follows: <sup>18</sup>F-NaF PET/CT had 100% sensitivity, 93.1% specificity, and 97.0% accuracy; MRI had 90.2% sensitivity, 98.6% specificity, and 93.9% accuracy; and the combination of <sup>18</sup>F-NaF PET/CT and MRI had 100% sensitivity, 97.2% specificity, and 98.8% accuracy. The accuracy rate of <sup>18</sup>F-NaF PET/CT combined with MRI were significantly higher than that of MRI alone (P<i>=</i>0.034). A total of 284, 243, and 276 SBBI lesions were diagnosed using <sup>18</sup>F-NaF PET/CT, MRI, and <sup>18</sup>F-NaF PET/CT combined with MRI, respectively. The diagnostic efficacy (sensitivity, specificity, and accuracy) at the lesion level was as follows: <sup>18</sup>F-NaF PET/CT had 99.6% sensitivity, 75.9% specificity, and 95.4% accuracy; MRI had 88.2% sensitivity, 93.1% specificity, and 89.1% accuracy; and the combination of <sup>18</sup>F-NaF PET/CT with MRI had 100% sensitivity, 91.4% specificity, and 98.5% accuracy. The combination of <sup>18</sup>F-NaF PET/CT with MRI significantly improved the accuracy rate compared to that of MRI alone, and the difference was statistically significant (P<0.001).</p><p><strong>Conclusions: </strong>The combined use of <sup>18</sup>F-NaF PET/CT and MRI significantly enhanced the diagnosis of SBBI in NPC patients, and the combined method had improved diagnostic sensitivity and accuracy than MRI alone.</p>\",\"PeriodicalId\":54267,\"journal\":{\"name\":\"Quantitative Imaging in Medicine and Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485363/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Quantitative Imaging in Medicine and Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/qims-24-265\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Quantitative Imaging in Medicine and Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/qims-24-265","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Enhanced detection of skull-base bone invasion in nasopharyngeal carcinoma: the supplementary diagnostic value of 18fluorine-sodium fluoride (18F-NaF) positron emission tomography/computed tomography (PET/CT) combined with magnetic resonance imaging (MRI).
Background: Nasopharyngeal carcinoma (NPC) originates in the nasopharyngeal mucosa, the lateral wall of the nasopharynx. A significant challenge in NPC management is skull-base bone invasion (SBBI), which affects prognosis and treatment planning. Magnetic resonance imaging (MRI) is the primary diagnostic tool for SBBI in NPC patients; however, the detection of SBBI can be challenging due to skull-base complexity and overlapping MRI signals. 18fluorine-sodium fluoride (18F-NaF) positron emission tomography/computed tomography (PET/CT) is an emerging imaging technique that has shown promise in detecting osseous lesions. This cohort study aimed to assess the supplementary diagnostic value of 18F-NaF PET/CT in detecting SBBI in NPC patients compared to that of MRI alone.
Methods: Imaging data were retrospectively collected from 18F-NaF PET/CT and head-and-neck MRI examinations conducted within a 7-day period. The sensitivity, specificity, and accuracy of 18F-NaF PET/CT, MRI, and the combination of both modalities in detecting SBBI were individually assessed. Both lesion- and patient-based analyses were employed for the comparison. Cochran's Q test was used to compare the accuracy of these methods, while the Bonferroni-corrected McNemar test was used for the pairwise comparisons. The data analysis was performed using the R software package, and a significance level of P<0.05 was considered statistically significant.
Results: A total of 164 patients were enrolled in the study. Using 18F-NaF PET/CT, MRI, and the combined modality of 18F-NaF PET/CT with MRI, 97, 84, and 94 cases of SBBI were diagnosed, respectively. At the patient level, the diagnostic efficacy (sensitivity, specificity, and accuracy) was as follows: 18F-NaF PET/CT had 100% sensitivity, 93.1% specificity, and 97.0% accuracy; MRI had 90.2% sensitivity, 98.6% specificity, and 93.9% accuracy; and the combination of 18F-NaF PET/CT and MRI had 100% sensitivity, 97.2% specificity, and 98.8% accuracy. The accuracy rate of 18F-NaF PET/CT combined with MRI were significantly higher than that of MRI alone (P=0.034). A total of 284, 243, and 276 SBBI lesions were diagnosed using 18F-NaF PET/CT, MRI, and 18F-NaF PET/CT combined with MRI, respectively. The diagnostic efficacy (sensitivity, specificity, and accuracy) at the lesion level was as follows: 18F-NaF PET/CT had 99.6% sensitivity, 75.9% specificity, and 95.4% accuracy; MRI had 88.2% sensitivity, 93.1% specificity, and 89.1% accuracy; and the combination of 18F-NaF PET/CT with MRI had 100% sensitivity, 91.4% specificity, and 98.5% accuracy. The combination of 18F-NaF PET/CT with MRI significantly improved the accuracy rate compared to that of MRI alone, and the difference was statistically significant (P<0.001).
Conclusions: The combined use of 18F-NaF PET/CT and MRI significantly enhanced the diagnosis of SBBI in NPC patients, and the combined method had improved diagnostic sensitivity and accuracy than MRI alone.