Comparison between The Diagnostic Performance of Positron Emission Tomography and Diffusion-Weighted MRI in Detecting Recurrence of Head and Neck Squamous Cell Carcinoma during Post Treatment Follow-up

Abstract

Background Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. (16) Despite aggressive combined-modality treatment regimens, there remains a high percentage (15-50%) of locoregional recurrences.(7) This problem make the clinician to rely on the functional imaging modalities such as Diffusion weighted MRI and Positron Emission Tomography to detect recurrence. Objective To perform a meta-analytical study on the comparison between the diagnostic role of DW/MRI and PET/CT scan in detecting recurrence of HNSCC during post-treatment follow-up. Methods This meta-analysis was conducted from 1/1/ 1998 to 31/3/2018 . Literature search on PubMed and Google scholar was done to identify randomised controlled trials and comparative studies either prospective or retrospective. MedCalc ver. 18.2 (MedCalc, Ostend, Belgium) was used for data analysis. Results Of the eight articles included, The meta-analysis was based on a total of 199 patients. All of them used DW/MRI and 186 of them used PET/CT. Comparative study between the two groups regarding sensitivity, specificity and accuracy revealed; highly significant difference in sensitivity in favor of PET/CT (p < 0.009), significant increase in specificity in favor of DW/MRI (p = 0.048) and no significant difference in accuracy between the two group. Conclusion PET/CT scan was found to be more sensitive than DW/MRI while DW/MRI was found to be more specific than PET/CT. Yet both have the same degree of accuracy.