Prospective comparative study of MRI including diffusion-weighted images versus FDG PET-CT for the detection of recurrent head and neck squamous cell carcinomas after (chemo)radiotherapy

Juliette P Driessen; Boris Peltenburg; Marielle E P Philippens; Julia E Huijbregts; Frank A Pameijer; Remco de Bree; Luuk M Janssen; Chris H J Terhaard

doi:10.1016/j.ejrad.2018.12.004

Prospective comparative study of MRI including diffusion-weighted images versus FDG PET-CT for the detection of recurrent head and neck squamous cell carcinomas after (chemo)radiotherapy

Eur J Radiol. 2019 Feb:111:62-67. doi: 10.1016/j.ejrad.2018.12.004. Epub 2018 Dec 5.

Authors

Juliette P Driessen¹, Boris Peltenburg², Marielle E P Philippens³, Julia E Huijbregts⁴, Frank A Pameijer⁵, Remco de Bree⁶, Luuk M Janssen⁶, Chris H J Terhaard³

Affiliations

¹ Department of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, the Netherlands.
² Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: [email protected].
³ Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands.
⁴ Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands.
⁵ Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands.
⁶ Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands.

PMID: 30691667
DOI: 10.1016/j.ejrad.2018.12.004

Abstract

Objective: This prospective study aims to test if MRI including diffusion weighted images can replace FDG PET-CT in the diagnosis of patients with suspicion of local recurrent head and neck squamous cell carcinomas after (chemo)radiation.

Methods: Seventy-five patients suspected of local recurrence underwent a MRI and a FDG PET-CT. Qualitative assessment of the images was performed. Reference standard was the results of biopsy or the absence of a recurrence during follow up.

Results: Seventy patients were included. Fifty percent had local recurrence. FDG PET-CT had accuracy of 71% compared to 73% for MRI. The sensitivity and specificity were 97% compared to 69% and 46% compared to 77% for FDG PET-CT and MRI respectively.

Conclusions: MRI showed similar diagnostic accuracy, superior specificity but inferior sensitivity compared to FDG PET-CT. Based on current results, we consider MRI including diffusion weighted sequences unable to replace FDG PET-CT as a single imaging modality when local recurrent disease of HNSCC after (C)RT is suspected.

Keywords: Chemoradiotherapy; Diffusion magnetic resonance imaging; Head and neck neoplasms; Neoplasm recurrence; Positron emission tomography computed tomography.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Aged, 80 and over
Chemoradiotherapy
Diffusion Magnetic Resonance Imaging* / methods
Female
Fluorodeoxyglucose F18
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / diagnostic imaging*
Neoplasm Recurrence, Local / pathology
Positron Emission Tomography Computed Tomography* / methods
Prospective Studies
Squamous Cell Carcinoma of Head and Neck / diagnostic imaging
Squamous Cell Carcinoma of Head and Neck / pathology*
Squamous Cell Carcinoma of Head and Neck / therapy

Substances

Fluorodeoxyglucose F18