Local recurrence of squamous cell carcinoma of the head and neck after radio(chemo)therapy: Diagnostic performance of FDG-PET/MRI with diffusion-weighted sequences

Purpose To determine the diagnostic performance of FDG-PET/MRI with diffusion-weighted imaging (FDG-PET/DWIMRI) for detection and local staging of head and neck squamous cell carcinoma (HNSCC) after radio(chemo)therapy. Materials and methods This was a prospective study that included 74 consecutive...

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Bibliographic Details
Published in:European radiology 2018-02, Vol.28 (2), p.651-663
Main Authors: Becker, Minerva, Varoquaux, Arthur D., Combescure, Christophe, Rager, Olivier, Pusztaszeri, Marc, Burkhardt, Karim, Delattre, Bénédicte M. A., Dulguerov, Pavel, Dulguerov, Nicolas, Katirtzidou, Eirini, Caparrotti, Francesca, Ratib, Osman, Zaidi, Habib, Becker, Christoph D.
Format: Article
Language:English
Subjects:
Adult
Aged
Benign
Biochemistry, Molecular Biology
Carcinoma, Squamous Cell - diagnosis
Carcinoma, Squamous Cell - therapy
Chemoradiotherapy
Chemotherapy
Clustering
Complementarity
Complications
Data processing
Diagnostic Radiology
Diagnostic systems
Diffusion Magnetic Resonance Imaging - methods
Female
Fluorodeoxyglucose F18 - pharmacology
Head & neck cancer
Head and Neck
Head and Neck Neoplasms - diagnosis
Head and Neck Neoplasms - therapy
Histology
Histopathology
Hospitals
Humans
Imaging
Internal Medicine
Interventional Radiology
Lesions
Life Sciences
Magnetic resonance imaging
Male
Medical diagnosis
Medicine
Medicine & Public Health
Metabolism
Middle Aged
Morphology
Neoplasm Recurrence, Local - diagnosis
Neuroradiology
Otolaryngology
Patients
Positron emission
Positron emission tomography
Positron-Emission Tomography - methods
Prospective Studies
Radiation
Radiation effects
Radiology
Radiopharmaceuticals - pharmacology
Salvage
Squamous cell carcinoma
Squamous Cell Carcinoma of Head and Neck
Statistical analysis
Surgery
Tomography
Tumors
Ultrasound
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Summary:Purpose To determine the diagnostic performance of FDG-PET/MRI with diffusion-weighted imaging (FDG-PET/DWIMRI) for detection and local staging of head and neck squamous cell carcinoma (HNSCC) after radio(chemo)therapy. Materials and methods This was a prospective study that included 74 consecutive patients with previous radio(chemo)therapy for HNSCC and in whom tumour recurrence or radiation-induced complications were suspected clinically. The patients underwent hybrid PET/MRI examinations with morphological MRI, DWI and FDG-PET. Experienced readers blinded to clinical/histopathological data evaluated images according to established diagnostic criteria taking into account the complementarity of multiparametric information. The standard of reference was histopathology with whole-organ sections and follow-up ≥24 months. Statistical analysis considered data clustering. Results The proof of diagnosis was histology in 46/74 (62.2%) patients and follow-up (mean ± SD = 34 ± 8 months) in 28/74 (37.8%). Thirty-eight patients had 43 HNSCCs and 46 patients (10 with and 36 without tumours) had 62 benign lesions/complications. Sensitivity, specificity, and positive and negative predictive value of PET/DWIMRI were 97.4%, 91.7%, 92.5% and 97.1% per patient, and 93.0%, 93.5%, 90.9%, and 95.1% per lesion, respectively. Agreement between imaging-based and pathological T-stage was excellent (kappa = 0.84, p  
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-017-4999-1