Significant value of 18F‐FDG‐PET/CT in diagnosing small cervical lymph node metastases in patients with nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy. Issue 1 (19th December 2017)

• Record Type: Journal Article
• Authors: Peng, Hao; Chen, Lei; Tang, Ling‐Long; Li, Wen‐Fei; Mao, Yan‐Ping; Guo, Rui; Zhang, Yuan; Liu, Li‐Zhi; Tian, Li; Zhang, Xu; Lin, Xiao‐Ping; Guo, Ying; Sun, Ying; Ma, Jun
• Is Part Of: Cancer communications. Volume 36:Issue 1(2017)
• Page Start: 1
• Page End: 10
• Publication Date: 2017-12-19
• Subjects: Nasopharyngeal carcinoma -- 18‐fluoro‐2‐deoxy‐glucose positron emission tomography with computed tomography (18F‐PET/CT) -- Magnetic resonance image -- Intensity‐modulated radiotherapy -- Small cervical lymph nodes; Cancer -- Periodicals; Neoplasms; Electronic journals; Periodical; Fulltext; Internet Resources; Periodicals; Periodicals; 616.994005
• DOI: 10.1186/s40880-017-0265-9
• Languages: English
• ISSNs: 2523-3548

Abstract

Abstract: Background: Little is known about the nature of metastasis to small cervical lymph nodes (SCLNs) in the patients with nasopharyngeal carcinoma (NPC) examined by using 18‐fluoro‐2‐deoxy‐glucose ( 18 F‐FDG) positron emission tomography/computed tomography (PET/CT). The present study aimed to evaluate the diagnostic values of PET/CT in identifying metastasis in SCLNs in NPC patients. Methods: Magnetic resonance images (MRI) and PET/CT scans for 470 patients with newly diagnosed, non‐distant metastatic NPC were analyzed. Metastatic rates of SCLNs were defined by the positive number of SCLNs on PET/CT scans and total number of SCLNs on MRI scans. Receiver operating characteristic curve was applied to compare PET/CT‐determined stage with MRI‐determined stage. Results: In total, 2082 SCLNs were identified, with 808 (38.8%) ≥ 5 and < 6 mm in diameter (group A), 526 (25.3%) ≥ 6 and < 7 mm in diameter (group B), 374 (18.0%) ≥ 7 and < 8 mm in diameter (group C), 237 (11.4%) ≥ 8 and < 9 mm in diameter (group D), and 137 (6.5%) ≥ 9 and < 10 mm in diameter (group E). The overall metastatic rates examined by using PET/CT for groups A, B, C, D, and E were 3.5%, 8.0%, 31.3%, 60.0%, and 83.9%, respectively ( P < 0.001). In level IV/Vb, the metastatic rate for nodes ≥ 8 mm was 84.6%. PET/CT examination resulted in modification of N category and overall stage for 135 (28.7%) and 46 (9.8%) patients, respectively. The areas under curve of MRI‐determined and PET/CT‐determined overall stage were 0.659 and 0.704 for predicting overall survival, 0.661 and 0.711 for predicting distant metastasis‐free survival, and 0.636 and 0.663 for predicting disease‐free survival. Conclusions: PET/CT was more effective than MRI in identifying metastatic SCLNs, and the radiologic diagnostic criteria for metastatic lymph nodes in level IV/Vb should be re‐defined.