[18F]FDG-PET/MRI Performance in Head-and-Neck Cancers at Initial Staging, Restaging and Follow Up

Area of Science:

• Radiology
• Oncology
• Nuclear Medicine

Background:

• Head-and-neck cancer (HNC) management necessitates precise pretreatment imaging assessment.
• Multimodality imaging, combining MRI and PET, offers comprehensive tumor characterization with synchronized spatiotemporal data.

Purpose of the Study:

• To evaluate the diagnostic performance of simultaneous [¹⁸F]FDG-PET/MR imaging for TNM staging in HNC patients.

Main Methods:

• A retrospective study included 117 HNC patients undergoing simultaneous [¹⁸F]FDG-PET/MR examinations.
• T and N staging were assessed using the AJCC 7th edition manual, with histopathology as the reference standard.
• Diagnostic metrics including sensitivity, specificity, predictive values, and accuracy were calculated.

Main Results:

• The overall accuracy of [¹⁸F]FDG-PET/MR for T-staging was 89%, with specific accuracies of 0.89 (initial), 0.83 (restaging), and 1 (follow-up).
• For lymph node staging, accuracy was 86% in patients with cervical node resection, with overall accuracy of 0.86 (initial), 0.92 (restaging), and 0.82 (follow-up).
• Detection rates for metastases and synchronous diseases were analyzed during patient follow-up.

Conclusions:

• Simultaneous [¹⁸F]FDG-PET/MR demonstrates excellent diagnostic performance for both T and N staging in HNC.
• The imaging modality shows high accuracy across initial staging, restaging, and follow-up evaluations in HNC patients.