Diagnostic value of retrospective PET-MRI fusion in head-and-neck cancer

• Published in: BMC cancer 2014-11, Vol.14 (1), p.846-846, Article 846
• Main Authors: Loeffelbein, Denys J, Souvatzoglou, Michael, Wankerl, Veronika, Dinges, Julia, Ritschl, Lucas M, Mücke, Thomas, Pickhard, Anja, Eiber, Matthias, Schwaiger, Markus, Beer, Ambros J
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Aged; Exocrine glands; Female; Fluorodeoxyglucose F18; Head & neck cancer; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - pathology; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Metastasis; Middle Aged; Neoplasm Staging; Patients; Positron-Emission Tomography; Reproducibility of Results; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Tomography; Tongue; Tumors
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/1471-2407-14-846

To assess the diagnostic value of retrospective PET-MRI fusion and to compare the results with side-by-side analysis and single modality use of PET and of MRI alone for locoregional tumour and nodal staging of head-and-neck cancer. Thirty-three patients with head-and-neck cancer underwent preoperative contrast-enhanced MRI and PET/CT for staging. The diagnostic data of MRI, PET, side-by-side analysis of MRI and PET images and retrospective PET-MRI fusion were systematically analysed for tumour and lymph node staging using receiver operating characteristic (ROC) analysis. The results were correlated to the histopathological evaluation. The overall sensitivity/specificity for tumour staging for MRI, PET, side-by-side analysis and retrospective PET-MRI fusion was 79%/66%, 82%/100%, 86%/100% and 89%/100%, respectively. The overall sensitivity/specificity for nodal staging on a patient basis for MRI, PET, side-by-side analysis and PET-MRI fusion was 94%/64%, 94%/91%, 94%/82% and 94%/82%, respectively. MRI, PET, side-by-side analysis and retrospective image fusion were associated with correct diagnosis/over-staging/under-staging of N-staging in 70.4%/18.5%/11.1%, 81.5%/7.4%/11.1%, 81.5%/11.1%/7.4% and 81.5%/11.1%/7.4%, respectively.ROC analysis showed no significant differences in tumor detection between the investigated methods. The Area Under the Curve (AUC) for MRI, PET, side-by-side analysis and retrospective PET-MRI fusion were 0.667/0.667/0.702/0.708 (p > 0.05). The most reliable technique in detection of cervical lymph node metastases was PET imaging (AUC: 0.95), followed by side-by-side analysis and retrospective image fusion technique (AUC: 0.941), which however, was not significantly better then the MRI (AUC 0.935; p > 0.05). We found a beneficial use of multimodal imaging, compared with MRI or PET imaging alone, particular in individual cases of recurrent tumour disease. Side-by-side analysis and retrospective image fusion analysis did not perform significantly differently.