Detection of residual head and neck squamous cell carcinoma after (chemo)radiotherapy: a pilot study assessing the value of diffusion-weighted magnetic resonance imaging as an adjunct to PET-CT using 18F-FDG

Daniel P. Noij, Viresh A. Jagesar, Pim de Graaf, Marcus C. de Jong, Otto S. Hoekstra, Remco de Bree, Jonas A. Castelijns

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective Diagnosing residual malignancy after (chemo)radiotherapy presents a diagnostic challenge because of overlapping symptoms and imaging characteristics. We assessed the added diagnostic value of diffusion-weighted imaging (DWI) to positron emission tomography combined with computed tomography (PET-CT) in patients with head and neck squamous cell carcinoma (HNSCC) with residual fluorodeoxyglucose (18F-FDG) uptake at the primary tumor site 3 months after (chemo)radiotherapy. Study Design For this retrospective study from January 2010 to June 2012, 22 cases (median patient age of 61 years; range 41-77 years) were included for analysis. Both PET-CT and magnetic resonance imaging (MRI), including DWI, were performed as part of the institutional protocol and were qualitatively assessed for the presence of residual malignancy at the primary tumor site. Results The sensitivity and specificity of PET-CT were 100% and 47%, respectively. For DWI, sensitivity and specificity were 80% and 82%, respectively. When DWI was added to PET-CT with residual 18F-FDG uptake, and only a positive read on both PET-CT and DWI was considered to be overall positive, sensitivity remained 80% (95% confidence interval [CI] 28%-99%), and specificity was 88% (95% CI 64%-99%). Conclusions In this pilot study of the selected patients with residual 18F-FDG uptake at the primary tumor site 3 months after (chemo)radiotherapy, we demonstrated that the addition of DWI to PET-CT has the potential to increase the specificity of the response evaluation with limited decrease in sensitivity.

Original languageEnglish
Pages (from-to)296-305.e2
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Volume124
Issue number3
DOIs
Publication statusPublished - 1 Sep 2017

Cite this

@article{318f28fef189465f8a0c920107f4a2f9,
title = "Detection of residual head and neck squamous cell carcinoma after (chemo)radiotherapy: a pilot study assessing the value of diffusion-weighted magnetic resonance imaging as an adjunct to PET-CT using 18F-FDG",
abstract = "Objective Diagnosing residual malignancy after (chemo)radiotherapy presents a diagnostic challenge because of overlapping symptoms and imaging characteristics. We assessed the added diagnostic value of diffusion-weighted imaging (DWI) to positron emission tomography combined with computed tomography (PET-CT) in patients with head and neck squamous cell carcinoma (HNSCC) with residual fluorodeoxyglucose (18F-FDG) uptake at the primary tumor site 3 months after (chemo)radiotherapy. Study Design For this retrospective study from January 2010 to June 2012, 22 cases (median patient age of 61 years; range 41-77 years) were included for analysis. Both PET-CT and magnetic resonance imaging (MRI), including DWI, were performed as part of the institutional protocol and were qualitatively assessed for the presence of residual malignancy at the primary tumor site. Results The sensitivity and specificity of PET-CT were 100{\%} and 47{\%}, respectively. For DWI, sensitivity and specificity were 80{\%} and 82{\%}, respectively. When DWI was added to PET-CT with residual 18F-FDG uptake, and only a positive read on both PET-CT and DWI was considered to be overall positive, sensitivity remained 80{\%} (95{\%} confidence interval [CI] 28{\%}-99{\%}), and specificity was 88{\%} (95{\%} CI 64{\%}-99{\%}). Conclusions In this pilot study of the selected patients with residual 18F-FDG uptake at the primary tumor site 3 months after (chemo)radiotherapy, we demonstrated that the addition of DWI to PET-CT has the potential to increase the specificity of the response evaluation with limited decrease in sensitivity.",
author = "Noij, {Daniel P.} and Jagesar, {Viresh A.} and {de Graaf}, Pim and {de Jong}, {Marcus C.} and Hoekstra, {Otto S.} and {de Bree}, Remco and Castelijns, {Jonas A.}",
year = "2017",
month = "9",
day = "1",
doi = "10.1016/j.oooo.2017.04.011",
language = "English",
volume = "124",
pages = "296--305.e2",
journal = "Oral surgery oral medicine oral pathology oral radiology",
issn = "2212-4403",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Detection of residual head and neck squamous cell carcinoma after (chemo)radiotherapy

T2 - a pilot study assessing the value of diffusion-weighted magnetic resonance imaging as an adjunct to PET-CT using 18F-FDG

AU - Noij, Daniel P.

AU - Jagesar, Viresh A.

AU - de Graaf, Pim

AU - de Jong, Marcus C.

AU - Hoekstra, Otto S.

AU - de Bree, Remco

AU - Castelijns, Jonas A.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Objective Diagnosing residual malignancy after (chemo)radiotherapy presents a diagnostic challenge because of overlapping symptoms and imaging characteristics. We assessed the added diagnostic value of diffusion-weighted imaging (DWI) to positron emission tomography combined with computed tomography (PET-CT) in patients with head and neck squamous cell carcinoma (HNSCC) with residual fluorodeoxyglucose (18F-FDG) uptake at the primary tumor site 3 months after (chemo)radiotherapy. Study Design For this retrospective study from January 2010 to June 2012, 22 cases (median patient age of 61 years; range 41-77 years) were included for analysis. Both PET-CT and magnetic resonance imaging (MRI), including DWI, were performed as part of the institutional protocol and were qualitatively assessed for the presence of residual malignancy at the primary tumor site. Results The sensitivity and specificity of PET-CT were 100% and 47%, respectively. For DWI, sensitivity and specificity were 80% and 82%, respectively. When DWI was added to PET-CT with residual 18F-FDG uptake, and only a positive read on both PET-CT and DWI was considered to be overall positive, sensitivity remained 80% (95% confidence interval [CI] 28%-99%), and specificity was 88% (95% CI 64%-99%). Conclusions In this pilot study of the selected patients with residual 18F-FDG uptake at the primary tumor site 3 months after (chemo)radiotherapy, we demonstrated that the addition of DWI to PET-CT has the potential to increase the specificity of the response evaluation with limited decrease in sensitivity.

AB - Objective Diagnosing residual malignancy after (chemo)radiotherapy presents a diagnostic challenge because of overlapping symptoms and imaging characteristics. We assessed the added diagnostic value of diffusion-weighted imaging (DWI) to positron emission tomography combined with computed tomography (PET-CT) in patients with head and neck squamous cell carcinoma (HNSCC) with residual fluorodeoxyglucose (18F-FDG) uptake at the primary tumor site 3 months after (chemo)radiotherapy. Study Design For this retrospective study from January 2010 to June 2012, 22 cases (median patient age of 61 years; range 41-77 years) were included for analysis. Both PET-CT and magnetic resonance imaging (MRI), including DWI, were performed as part of the institutional protocol and were qualitatively assessed for the presence of residual malignancy at the primary tumor site. Results The sensitivity and specificity of PET-CT were 100% and 47%, respectively. For DWI, sensitivity and specificity were 80% and 82%, respectively. When DWI was added to PET-CT with residual 18F-FDG uptake, and only a positive read on both PET-CT and DWI was considered to be overall positive, sensitivity remained 80% (95% confidence interval [CI] 28%-99%), and specificity was 88% (95% CI 64%-99%). Conclusions In this pilot study of the selected patients with residual 18F-FDG uptake at the primary tumor site 3 months after (chemo)radiotherapy, we demonstrated that the addition of DWI to PET-CT has the potential to increase the specificity of the response evaluation with limited decrease in sensitivity.

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U2 - 10.1016/j.oooo.2017.04.011

DO - 10.1016/j.oooo.2017.04.011

M3 - Article

VL - 124

SP - 296-305.e2

JO - Oral surgery oral medicine oral pathology oral radiology

JF - Oral surgery oral medicine oral pathology oral radiology

SN - 2212-4403

IS - 3

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