Use of MRI and FDG-PET/CT to predict fixation of advanced hypopharyngeal squamous cell carcinoma to prevertebral space

Head Neck. 2019 Feb;41(2):503-510. doi: 10.1002/hed.25431. Epub 2018 Dec 18.

Abstract

Background: We evaluated the ability of different (18F)fluoro-deoxy-d-glucose (FDG)-positron emission tomography (PET)-based and magnetic resonance (MR)-based parameters to identify prevertebral space (PVS) infiltration by hypopharyngeal carcinoma.

Methods: Retrospective study on 59 patients with advanced hypopharyngeal squamous cell carcinoma undergoing cross-sectional imaging and triple endoscopy for staging.

Results: Obliteration of retropharyngeal fat plane on T1-weighted MR images was found more often (P < .001) in tumors fixated to the PVS. Complete fat plane obliteration best predicted tumor fixation to PVS (accuracy 99%; CI: 97%-100%; P < .001). With similar accuracy, PET-based models predicted PVS fixation (combination of standardized uptake value [SUVmax ] of the primary tumor and presence of focal FDG-uptake in prevertebral muscles [accuracy 98%; CI 94%-100%; P < .001]; metabolic tumor volume [MTV] [accuracy 98%; CI 95%-100%; P < .001]).

Conclusion: Both the MR-based parameter of complete fat plane obliteration and PET-based models (increased SUVmax in combination with presence of focal FDG-uptake of prevertebral muscles; increased MTV) predict PVS involvement independently with high accuracy.

Keywords: (18F)fluoro-deoxy-d-glucose (FDG) positron emission tomography (PET) - CT (PET/CT); (18F)fluoro-deoxy-d-glucose (FDG) positron emission tomography (PET) - magnetic resonance (MR) (PET/MR) imaging; head and neck squamous cell carcinoma (HNSCC); prevertebral space (PVS); resectability.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / pathology
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Hypopharyngeal Neoplasms / diagnostic imaging*
  • Hypopharyngeal Neoplasms / pathology*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spine / diagnostic imaging
  • Spine / pathology*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18