Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous <sup>18</sup>F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Pyatigorskaya, Nadya; Laroche, Romain; Bera, G.; Giron, Alain; Bertolus, Chloé; Hervé, G.; Chambenois, Edouard; Bergeret, Sébastien; Dormont, Didier; Amor-Sahli, M.; Kas, Aurélie

doi:10.3174/ajnr.a6764

Cited by 9 publications

(6 citation statements)

References 38 publications

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“…15 Pyatigorskaya et al reported a sensitivity of 90% and specificity of 98%. 22 Similar to the studies mentioned above, we achieved a high sensitivity of 91.7% and high specificity of 92.35%.…”

Section: Discussionsupporting

confidence: 83%

Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

Nie¹,

Zhou²,

Zeng³

et al. 2022

Adv Clin Exp Med

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Background. Perineural spread of head and neck tumors is linked to a worse chance of survival as well as a higher risk of local recurrence and metastasis. Particle emission tomography/computed tomography (PET/CT) using 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) is part of the work-up and follow-up of many afflicted patients, and radiologists play an essential role in the assessment and management of head and neck cancer.Objectives. The purpose of the current study was to investigate the diagnostic performance of 18 F-FDG PET in detecting perineural spread among patients with head and neck tumors through a meta-analysis. Materials and methods.Relevant articles were searched using appropriate keywords from PubMed, MEDLINE and PubMed Central (PMC) databases. Retrospective and prospective studies were included as per the predefined PICOS criteria. Demographic summary and event data for diagnostic accuracy of 18 F-FDG PET were determined, and odds ratio (OR), sensitivity, specificity, likelihood ratios, and predictive values were calculated using RevMan software. The bias risk was analyzed with Egger's and Begg's tests using MedCalc software. Results.Fourteen clinical trials performed between 2000 and 2021, with 977 head and neck cancer patients with perineural spread, were included according to the inclusion criteria. Included studies used 18 F-FDG PET imaging of tumors and reported its high sensitivity. In the current study, we obtained the pooled OR = 3.088 (95% confidence interval (95% CI): [1.486; 6.419]), pooled sensitivity of 91.7%, pooled specificity of 92.35%, positive predictive value (PPV) of 92.27%, negative predictive value (NPV) of 91. 13%, positive likelihood ratio of 7.45, negative likelihood ratio of 0.28, disease prevalence of 95.8%, and accuracy of 91.5%. Data was heterogeneous, with Q value of 33.8%, degrees of freedom (df) value of 13, I 2 value of 61.5% (31.23-78.5), and p-value = 0.0013. The risk of publication bias was low, with a p = 0.7490 (Egger's test) and p = 0.7843 (Begg's test).Conclusions. The present meta-analysis highly recommends 18 F-FDG PET as an effective imaging method for patients with head and neck tumors with perineural spread.

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Section: Discussionsupporting

confidence: 83%

Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

Nie¹,

Zhou²,

Zeng³

et al. 2022

Adv Clin Exp Med

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“…Recent literature has argued that gadolinium-enhanced MR images are not needed for accurate characterization of lesions because metabolic data from PET may offer similar information. 26 Thus, PET/MR imaging times could potentially be shortened even further.…”

Section: Discussionmentioning

confidence: 99%

PET/MR Imaging in Evaluating Treatment Failure of Head and Neck Malignancies: A Neck Imaging Reporting and Data System–Based Study

Patel

Bridgham

Ciriello

et al. 2022

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: PET/MR imaging is a relatively new hybrid technology that holds great promise for the evaluation of head and neck cancer. The aim of this study was to assess the performance of simultaneous PET/MR imaging versus MR imaging in the evaluation of posttreatment head and neck malignancies, as determined by its ability to predict locoregional recurrence or progression after imaging. MATERIALS AND METHODS:The electronic medical records of patients who had posttreatment PET/MR imaging studies were reviewed, and after applying the exclusion criteria, we retrospectively included 46 studies. PET/MR imaging studies were independently reviewed by 2 neuroradiologists, who recorded scores based on the Neck Imaging Reporting and Data System (using CT/PET-CT criteria) for the diagnostic MR imaging sequences alone and the combined PET/MR imaging. Treatment failure was determined with either biopsy pathology or initiation of new treatment. Statistical analyses including univariate association, interobserver agreement, and receiver operating characteristic analysis were performed. RESULTS:There was substantial interreader agreement among PET/MR imaging scores (k ¼ 0.634; 95% CI, 0.605-0.663). PET/MR imaging scores showed a strong association with treatment failure by univariate association analysis, with P , .001 for the primary site, neck lymph nodes, and combined sites. Receiver operating characteristic curves of PET/MR imaging scores versus treatment failure indicated statistically significant diagnostic accuracy (area under curve range, 0.864-0.987; P , .001).CONCLUSIONS: Simultaneous PET/MR imaging has excellent discriminatory performance for treatment outcomes of head and neck malignancy when the Neck Imaging Reporting and Data System is applied. PET/MR imaging could play an important role in surveillance imaging for head and neck cancer.

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“…In the first step, the tumor lesion was segmented on FDG PET images by thresholding 40% of the standardized maximum uptake value [ 19 ] to give the metabolic tumor volume ( Figure 1 (a1)). In the second step, the tumor lesion was segmented from the weighted MRI image set.…”

Section: Methodsmentioning

confidence: 99%

Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers

Gouel

Callonnec

Obongo-Anga

et al. 2023

Cancers

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Intratumoral hypoxia is associated with a poor prognosis and poor response to treatment in head and neck cancers. Its identification would allow for increasing the radiation dose to hypoxic tumor subvolumes. 18F-FMISO PET imaging is the gold standard; however, quantitative multiparametric MRI could show the presence of intratumoral hypoxia. Thus, 16 patients were prospectively included and underwent 18F-FDG PET/CT, 18F-FMISO PET/CT, and multiparametric quantitative MRI (DCE, diffusion and relaxometry T1 and T2 techniques) in the same position before treatment. PET and MRI sub-volumes were segmented and classified as hypoxic or non-hypoxic volumes to compare quantitative MRI parameters between normoxic and hypoxic volumes. In total, 13 patients had hypoxic lesions. The Dice, Jaccard, and overlap fraction similarity indices were 0.43, 0.28, and 0.71, respectively, between the FDG PET and MRI-measured lesion volumes, showing that the FDG PET tumor volume is partially contained within the MRI tumor volume. The results showed significant differences in the parameters of SUV in FDG and FMISO PET between patients with and without measurable hypoxic lesions. The quantitative MRI parameters of ADC, T1 max mapping and T2 max mapping were different between hypoxic and normoxic subvolumes. Quantitative MRI, based on free water diffusion and T1 and T2 mapping, seems to be able to identify intra-tumoral hypoxic sub-volumes for additional radiotherapy doses.

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Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Cited by 9 publications

References 38 publications

Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

PET/MR Imaging in Evaluating Treatment Failure of Head and Neck Malignancies: A Neck Imaging Reporting and Data System–Based Study

Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers

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Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous 18F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?

Cited by 9 publications

References 38 publications

Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

Does PET scan have any role in the diagnosis of perineural spread associated with the head and neck tumors?

PET/MR Imaging in Evaluating Treatment Failure of Head and Neck Malignancies: A Neck Imaging Reporting and Data System–Based Study

Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers

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Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous ¹⁸F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?