Skull base erosion in nasopharyngeal carcinoma: Detection by CT and MRI

Chong, Vincent; Fan, Y.F.

doi:10.1016/s0009-9260(96)80056-0

Cited by 99 publications

(38 citation statements)

References 6 publications

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“…It is well established that MR is better than CT at identifying invasion of the skull base, and it has now become common practice to use MRI for pretreatment evaluation of patients with NPC. 10 Our results showed that abnormal MR signal intensity in the skull base was correlated with the risk of tumour recurrence. Univariate and multivariate analyses demonstrated that invasion of the skull base, as determined by MRI, was significantly associated with local control.…”

Section: Discussionsupporting

confidence: 49%

MR imaging prediction of local control of nasopharyngeal carcinoma treated with radiation therapy and chemotherapy

Wang¹,

Zhao²,

Zhang³

et al. 2014

BJR

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Section: Discussionsupporting

confidence: 49%

MR imaging prediction of local control of nasopharyngeal carcinoma treated with radiation therapy and chemotherapy

Wang¹,

Zhao²,

Zhang³

et al. 2014

BJR

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“…The higher sensitivity of magnetic resonance imaging (MRI) allows more accurate evaluation of the local tumor extension and the nodal spread pattern than computerized tomography (CT), thereby improving the accuracy of the classification and changing the treatment strategies for NPC (13,14). Furthermore, the implementation of three-dimensional conformal radiotherapy (3-DCRT) and, particularly, intensity-modulated radiation therapy (IMRT) requires the delineation of the target volume in cross-sectional imaging and the standardization of the terminology and procedures for neck irradiation.…”

mentioning

confidence: 99%

The N Staging System in Nasopharyngeal Carcinoma with Radiation Therapy Oncology Group Guidelines for Lymph Node Levels Based on Magnetic Resonance Imaging

Mao¹,

Liang²,

Liu³

et al. 2008

Clinical Cancer Research

136

130

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Purpose:To evaluate the prognostic value of variables including nodal size, level, laterality, extranodal neoplastic spread (ENS), and necrosis in patients with nasopharyngeal carcinoma (NPC) and further explore the feasibility of an N-staging system using Radiation Therapy Oncology Group (RTOG) guidelines for lymph node levels based on magnetic resonance imaging (MRI). Experimental Design: The MRI scans of 924 patients with histologically diagnosed nondisseminated NPC were reviewed retrospectively. The distribution of the tumors was mapped using RTOG guidelines and laterality. The multiplicity of each tumor was calculated, as well as the size and status of ENS and the necrosis of individual nodes. Results: Nodal level, cervical lymph node laterality, and ENS were independent prognostic factors for disease failure and distant failure in multivariate analyses. There was no significant difference in the hazard ratios (HR) for distant failure between level II and retropharyngeal, level Ib, levelV, or level III involvement, whereas patients with level IVand supraclavicular fossa involvement had a significant increase in HRs. The subsets that made up a given N stage group had similar HRs for distant failure. Both the HRs for disease failure and distant failure by the proposed N staging system between one stage and the next were statistically significant (P < 0.05). The survival curves of disease-free survival and distant metastasis-free survival for all subclassifications of N stage showed significant difference from the adjacent stage (P < 0.05). The overall distribution pattern of the proposed N staging was more equitable than that of the 6th American Joint Committee on Cancer N staging. Conclusions: Nodal variables including level, cervical lymph node laterality, and ENS are independent prognostic factors for NPC. The proposed N staging system of NPC using RTOG guidelines based on MRI is highly predictive and may provide a more objective method for staging NPCs.

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“…3 MRI has also been reported to reveal the extent of invasion of the tumour into the structures around the mass more accurately than a CT, 4 and has been reported to be superior than a CT in demonstrating the lesions in the retropharyngeal node, skull base, intracranial area, carotid space, longus colli muscle, and levator palatani muscles. 5 It has also been commented that infiltration and destruction of the skull base is more easily visualized on an MRI than a CT. 6 It would therefore be very interesting to know if an MRI scan was performed to look for possible compression or invasion of the nerve by the tumour before postulating a dual pathology or a paraneoplastic effect, as it appears that such an important investigation has not been performed. Even so, a microinvasion of the nerve causing the neuritis cannot be ruled out.Improvement in the vision following methylprednisolone can be explained on the basis of the reduction in the compressive effect following treatment.…”

Section: Replymentioning

confidence: 99%