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30.10.2017 | Head and Neck

Diagnostic and prognostic value of 18F-FDG PET, CT, and MRI in perineural spread of head and neck malignancies

verfasst von: Laurent Dercle, Dana Hartl, Laura Rozenblum-Beddok, Fatima-Zohra Mokrane, Romain-David Seban, Randy Yeh, François Bidault, Samy Ammari

Erschienen in: European Radiology | Ausgabe 4/2018

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Abstract

Objectives

We assessed whether quantitative imaging biomarkers derived from fluorodeoxyglucose-positron emission tomography (18F-FDG PET) could be extracted from perineural spread (PNS) in head and neck malignancies (HNM) to improve patient risk stratification.

Methods

A case–control exploratory study (1:2 ratio) enrolled 81 patients with FDG-avid HNM. The case-group comprised 28 patients with documented PNS (reference: expert consensus), including 14 squamous cell carcinomas (SCC). Imaging biomarkers were extracted from the PNS on 18F-FDG PET, CT-scan, and MRI. The control-group enrolled 53 SCCs. The Cox proportional-hazards regression model explored the association with overall survival by univariate and multivariate analyses.

Results

The rate of PNS detection by 18F-FDG PET was 100% in the case-group. Quantitative imaging biomarkers were not associated with the presence of sensory (p>0.20) or motor (p>0.10) symptoms. In SCC patients (case: 14; control: 53), PNS was associated with a hazard ratio of death of 5.5 (95%CI: 1.4:20.9) by multivariate analysis. Increased cranial nerve SUV_max was significantly associated with poorer overall survival by univariate analysis (p=0.001).

Conclusions

Our pilot study showed the feasibility of extracting 18F-FDG PET biomarkers from PNS in FDG-avid HNM. Our results encourage the development of new PET/CT- or PET/MRI-guided management strategies in further prospective studies.

Key Points

• 18F-FDG PET/CT detects PNS in FDG-avid HNM.

• PNS metabolism is more heterogeneous than healthy tissue.

• PNS diagnosis is crucial: most patients were asymptomatic, N0 and M0.

• PNS diagnosis is associated with poorer overall survival in SCC.

• PET/CT- or PET/MRI-guided management strategies should be evaluated.

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Titel: Diagnostic and prognostic value of 18F-FDG PET, CT, and MRI in perineural spread of head and neck malignancies
verfasst von: Laurent Dercle
Dana Hartl
Laura Rozenblum-Beddok
Fatima-Zohra Mokrane
Romain-David Seban
Randy Yeh
François Bidault
Samy Ammari
Publikationsdatum: 30.10.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 4/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5063-x

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Diagnostic and prognostic value of 18F-FDG PET, CT, and MRI in perineural spread of head and neck malignancies

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Abstract

Objectives

Methods

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Conclusions

Key Points

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