PET/CT for staging and follow-up of pediatric nasopharyngeal carcinoma

Daniel K.L. Cheuk, Noah D. Sabin, Moinul Hossain, Amy Wozniak, Mihir Naik, Carlos Rodriguez-Galindo, Matthew J. Krasin, Barry L. Shulkin

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose: While FDG PET/CT for the evaluation of nasopharyngeal carcinoma (NPC) in adult patients has documented advantages and disadvantages compared with conventional imaging, to our knowledge, no studies of FDG PET/CT for the evaluation of NPC in pediatric patients have been performed. In this investigation, we studied the utility of FDG PET/CT in children with NPC. Methods: The study group comprised 18 children with biopsy-proven NPC who underwent FDG PET/CT and MRI (total 38 pairs of images). All baseline and follow-up FDG PET/CT and MRI studies were independently reviewed for restaging of disease. Results: The concordance between FDG PET/CT and MRI in T, N, and overall staging was 29%, 64%, and 43%, respectively. Compared with MRI, FDG PET/CT yielded lower T and overall staging and showed less cervical and retropharyngeal lymphadenopathy. The concordance between follow-up FDG PET/CT and MRI was 79% overall and 100% 9 months after therapy. In patients who achieved complete remission, FDG PET/CT showed disease clearance 3-6 months earlier than MRI. There were no false-positive or false-negative FDG PET/CT scans during follow-up. Conclusion: FDG PET/CT may underestimate tumor extent and regional lymphadenopathy compared with MRI at the time of diagnosis, but it helps to detect metastases and clarify ambiguous findings. FDG PET/CT is sensitive and specific for follow-up and enables earlier determination of disease remission. FDG PET/CT is a valuable imaging modality for the evaluation and monitoring of NPC in pediatric patients.

Original languageEnglish (US)
Pages (from-to)1097-1106
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume39
Issue number7
DOIs
StatePublished - Jul 2012

Keywords

  • Child
  • Magnetic resonance imaging
  • Nasopharyngeal carcinoma
  • Positron emission tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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