Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography

Joseph Tung Chieh Chang, Sheng Chieh Chan, Tzu Chen Yen, Chun Ta Liao, Chien Yu Lin, Kun Ju Lin, I. How Chen, Hung Ming Wang, Yu Chen Chang, Tsung-Ming Chen, Chung Jan Kang, Shu Hang Ng

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Abstract

Purpose: Nasopharyngeal carcinoma (NPC) has a high rate of neck lymph node and/or distant metastasis. We evaluated the value of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in staging NPC, especially in the detection of distant metastasis. Methods and Materials: A total of 95 patients, including 85 with primary and 10 with recurrent, NPC were enrolled. Dual-phase FDG-PET was used, in addition to the conventional workup. Eighty-one patients without distant metastases underwent repeat studies 3-4 months after initial radical treatment. Results: Of 14 patients with distant metastases, all had lesions detected by FDG-PET, and the conventional workup detected the metastases in only 4. Two patients had false-positive MRI findings for neck node metastasis, but the FDG-PET findings were accurate. Four patients without distant metastases on their initial workup were found to have new lesions on FDG-PET 3-4 months after initial treatment. Patients with advanced node disease had a significantly greater incidence of distant metastases on FDG-PET, especially for N3 disease. Of the 95 patients, the FDG-PET results for distant metastasis were true positive in 14 patients, false positive in 8, and true negative in 73. None of our patients had a false-negative result. For a patient base, the sensitivity and specificity of FDG-PET for distant metastasis was 100% and 90.1% (95% confidence interval 81.5-95.6%), respectively, in this study. The accuracy was 91.6% (95% confidence interval 84.1-96.3%), the positive predictive value was 63.6 (95% confidence interval 40.7-82.8%), and the negative predictive value was 100%. Conclusion: FDG-PET stages N and M disease of NPC more accurately and sensitively than does the conventional workup. Patients with advanced node disease, particularly N3 disease, would benefit the most from FDG-PET.

Original languageEnglish
Pages (from-to)501-507
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume62
Issue number2
DOIs
Publication statusPublished - Jun 1 2005
Externally publishedYes

Keywords

  • Conventional workup
  • FDG-PET
  • Metastases
  • Nasopharyngeal carcinoma
  • TNM staging

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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  • Cite this

    Chang, J. T. C., Chan, S. C., Yen, T. C., Liao, C. T., Lin, C. Y., Lin, K. J., Chen, I. H., Wang, H. M., Chang, Y. C., Chen, T-M., Kang, C. J., & Ng, S. H. (2005). Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography. International Journal of Radiation Oncology Biology Physics, 62(2), 501-507. https://doi.org/10.1016/j.ijrobp.2004.09.057