PET/MRI and PET/CT in follow-up of head and neck cancer patients

• DOI: 10.1007/s00259-014-2707-9
• Publication Date: 2014-02-27T15:52:07Z
• Authors: Marcelo A. Queiroz; Martin Hüllner; Felix Kuhn; Gerhardt Huber; Christian Meerwein; Spyros Kollias; Gustav von Schult...; Patrick Veit-Haibach
• Keywords: Adult; Male; 610 Medicine & health; Multimodal Imaging; 03 medical and health sciences; 0302 clinical medicine; 10043 Clinic for Neuroradiology; Fluorodeoxyglucose F18; Predictive Value of Tests; 2741 Radiology, Nuclear Medicine and Imaging; Humans; Prospective Studies; Aged; Aged, 80 and over; Carcinoma; 10181 Clinic for Nuclear Medicine; Middle Aged; Magnetic Resonance Imaging; 3. Good health; Head and Neck Neoplasms; Positron-Emission Tomography; Female; Radiopharmaceuticals; Tomography, X-Ray Computed; Follow-Up Studies

Positron emission tomography (PET)/MRI combines the functional ability of PET and the high soft tissue contrast of MRI. The aim of this study was to assess contrast-enhanced (ce)PET/MRI compared to cePET/CT in patients with suspected recurrence of head and neck cancer (HNC).Eighty-seven patients underwent sequential cePET/CT and cePET/MRI using a trimodality PET/CT-MRI set-up. Diagnostic accuracy for the detection of recurrent HNC was evaluated using cePET/CT and cePET/MRI. Furthermore, image quality, presence of unclear (18)F-fluorodeoxy-D-glucose (FDG) findings of uncertain significance and the diagnostic advantages of use of gadolinium contrast enhancement were analysed.cePET/MRI showed no statistically significant difference in diagnostic accuracy compared to cePET/CT (91.5 vs 90.6%). Artefacts' grade was similar in both methods, but their location was different. cePET/CT artefacts were primarily located in the suprahyoid area, while on cePET/MRI, artefacts were more equally distributed among the supra and infrahyoid neck regions. cePET/MRI and cePET/CT showed 34 unclear FDG findings; of those 11 could be solved by cePET/MRI and 5 by cePET/CT. The use of gadolinium in PET/MRI did not yield higher diagnostic accuracy, but helped to better define tumour margins in 6.9% of patients.Our data suggest that cePET/MRI may be superior compared to cePET/CT to specify unclear FDG uptake related to possible tumour recurrence in follow-up of patients after HNC. It seems to be the modality of choice for the evaluation of the oropharynx and the oral cavity because of a higher incidence of artefacts in cePET/CT in this area mainly due to dental implants. However, overall there is no statistically significant difference.