Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer

Introduction: Surgical treatment options are limited for nasopharyngeal cancer for many reasons including epidemiological and histological properties, proximity to important structures, heavy lymphatic drainage, and the difficulty in ensuring a safe surgical margin; therefore primary treatment is ge...

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Autores principales:	Semih Ak, Caner Kiliç, Samet Özlügedik
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Nasopharynx cancer PET-CT MR Histopathology Otorhinolaryngology RF1-547
Acceso en línea:	https://doaj.org/article/39ef7dd6f8a544a582c4eec9b977d642
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spelling	oai:doaj.org-article:39ef7dd6f8a544a582c4eec9b977d6422021-11-06T04:23:23ZCorrelation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer1808-869410.1016/j.bjorl.2019.12.004https://doaj.org/article/39ef7dd6f8a544a582c4eec9b977d6422021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1808869420300045https://doaj.org/toc/1808-8694Introduction: Surgical treatment options are limited for nasopharyngeal cancer for many reasons including epidemiological and histological properties, proximity to important structures, heavy lymphatic drainage, and the difficulty in ensuring a safe surgical margin; therefore primary treatment is generally radiotherapy and chemotherapy. With current radiotherapy technology, oncological success has been increased and the quality of life of patients during the post- radiotherapy period is improved. Objective: The role of magnetic resonance imaging and positron emission-computed tomography in the follow-up of recurrent nasopharyngeal cancer patients who were initially treated with radiotherapy was evaluated with respect to histopathological findings. Methods: A total of 110 patients with nasopharyngeal cancer who had received radiotherapy were included in the study. Patients who were suspected to have recurrence according to endoscopic nasopharyngeal examination and magnetic resonance imaging findings were requested to undergo positron emission-computed tomography. Biopsies were taken from 40 patients who had suspicious lesions in positron emission-computed tomography images. These patients’ age, gender, presence/absence of contrast enhancement on magnetic resonance imaging, the SuvMax values of nasopharyngeal and neck lesions, T/N phases at initial diagnosis, histopathological recurrence, and history of neck dissection were assessed. Results: Recurrence was observed in 8 patients (20.0%). Among these, 4 (10.0%) had recurrence at the nasopharynx and 4 (10.0%) at the neck. Patients with recurrence were found to be of older age, male gender, advanced T/N phase, contrast enhancement on magnetic resonance imaging, and higher nasopharyngeal and neck SuvMax values in positron emission-computed tomography. However, these differences were not statistically significant. Only the history of neck dissection was significantly more common among those with recurrence (p < 0.001). However, in multivariate analysis, those with a nasopharyngeal SuvMax value higher than 4.58 were found to have 7.667-fold higher risk for recurrence (p = 0.036). Conclusions: Magnetic resonance imaging and positron emission-computed tomography should be evaluated together in the follow-up of nasopharyngeal cancer. Patients with minimal SuvMax 4.58 on positron emission-computed tomography after contrast enhancement in the T2 sequence on magnetic resonance imaging may considered appropriate for biopsy. Biopsies in patients with a SuvMax value lower than 4.58 can be avoided. Thus, patients avoid surgical stress and unnecessary costs.Semih AkCaner KiliçSamet ÖzlügedikElsevierarticleNasopharynx cancerPET-CTMRHistopathologyOtorhinolaryngologyRF1-547ENBrazilian Journal of Otorhinolaryngology, Vol 87, Iss 6, Pp 643-648 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Nasopharynx cancer PET-CT MR Histopathology Otorhinolaryngology RF1-547
spellingShingle	Nasopharynx cancer PET-CT MR Histopathology Otorhinolaryngology RF1-547 Semih Ak Caner Kiliç Samet Özlügedik Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer
description	Introduction: Surgical treatment options are limited for nasopharyngeal cancer for many reasons including epidemiological and histological properties, proximity to important structures, heavy lymphatic drainage, and the difficulty in ensuring a safe surgical margin; therefore primary treatment is generally radiotherapy and chemotherapy. With current radiotherapy technology, oncological success has been increased and the quality of life of patients during the post- radiotherapy period is improved. Objective: The role of magnetic resonance imaging and positron emission-computed tomography in the follow-up of recurrent nasopharyngeal cancer patients who were initially treated with radiotherapy was evaluated with respect to histopathological findings. Methods: A total of 110 patients with nasopharyngeal cancer who had received radiotherapy were included in the study. Patients who were suspected to have recurrence according to endoscopic nasopharyngeal examination and magnetic resonance imaging findings were requested to undergo positron emission-computed tomography. Biopsies were taken from 40 patients who had suspicious lesions in positron emission-computed tomography images. These patients’ age, gender, presence/absence of contrast enhancement on magnetic resonance imaging, the SuvMax values of nasopharyngeal and neck lesions, T/N phases at initial diagnosis, histopathological recurrence, and history of neck dissection were assessed. Results: Recurrence was observed in 8 patients (20.0%). Among these, 4 (10.0%) had recurrence at the nasopharynx and 4 (10.0%) at the neck. Patients with recurrence were found to be of older age, male gender, advanced T/N phase, contrast enhancement on magnetic resonance imaging, and higher nasopharyngeal and neck SuvMax values in positron emission-computed tomography. However, these differences were not statistically significant. Only the history of neck dissection was significantly more common among those with recurrence (p < 0.001). However, in multivariate analysis, those with a nasopharyngeal SuvMax value higher than 4.58 were found to have 7.667-fold higher risk for recurrence (p = 0.036). Conclusions: Magnetic resonance imaging and positron emission-computed tomography should be evaluated together in the follow-up of nasopharyngeal cancer. Patients with minimal SuvMax 4.58 on positron emission-computed tomography after contrast enhancement in the T2 sequence on magnetic resonance imaging may considered appropriate for biopsy. Biopsies in patients with a SuvMax value lower than 4.58 can be avoided. Thus, patients avoid surgical stress and unnecessary costs.
format	article
author	Semih Ak Caner Kiliç Samet Özlügedik
author_facet	Semih Ak Caner Kiliç Samet Özlügedik
author_sort	Semih Ak
title	Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer
title_short	Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer
title_full	Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer
title_fullStr	Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer
title_full_unstemmed	Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer
title_sort	correlation of pet-ct, mri and histopathology findings in the follow-up of patients with nasopharyngeal cancer
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/39ef7dd6f8a544a582c4eec9b977d642
work_keys_str_mv	AT semihak correlationofpetctmriandhistopathologyfindingsinthefollowupofpatientswithnasopharyngealcancer AT canerkilic correlationofpetctmriandhistopathologyfindingsinthefollowupofpatientswithnasopharyngealcancer AT sametozlugedik correlationofpetctmriandhistopathologyfindingsinthefollowupofpatientswithnasopharyngealcancer
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Correlation of PET-CT, MRI and histopathology findings in the follow-up of patients with nasopharyngeal cancer

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