Combined multimodal co-registration of PET/CT and MRI images increases diagnostic accuracy in squamous cell carcinoma staging

• DOI: 10.1007/s11547-015-0617-y
• Publication Date: 2016-01-11T14:57:50Z
• Authors: Alessandro Stecco; Silvio Ciolfi; Francesco Buemi; Alessia Cassarà; Gian Mauro Sacchetti; Marco Brambilla; Alessandro Carriero
• Keywords: Adult; Male; PET/CT; 610; Multimodal Imaging; Sensitivity and Specificity; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Positron Emission Tomography Computed Tomography; Humans; Aged; Neoplasm Staging; Retrospective Studies; Co-registration; Middle Aged; SCC; 3. Good health; Diffusion Magnetic Resonance Imaging; Head and Neck Neoplasms; PET-MRI; Lymphatic Metastasis; Carcinoma, Squamous Cell; Female; MRI

The purpose of our study was to assess the diagnostic value of multi-modal imaging through co-registration of short tau inversion recovery (STIR) and diffusion-weighted imaging (DWI) MRI with (18)FDG-PET/CT in T and N staging of head and neck tumours.25 patients with head and neck squamous cell carcinoma who had undergone MRI and PET/CT before treatment were retrospectively evaluated. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PET/CT, MRI and their combined use were assessed in T and N staging. Histopathology and follow-up imaging results were used as the gold standard.In assessing trans-compartmental extensions, PET-MRI showed 93 % sensitivity, 88 % specificity, 94 % PPV, and 88 % NPV, as compared to the 94 and 53 % sensitivity, 75 and 75 % specificity, 89 and 82 % PPV, and 86 and 43 % demonstrated by MRI and PET, respectively. In the identification of pathological lymph nodes, PET-MRI showed 92 % sensitivity, 89 % specificity, 96 % PPV, and 89 % NPV, whereas PET/CT displayed 72 % sensitivity, 89 % specificity, 95 % PPV and 53 % NPV. The corresponding figures for DWI and STIR sequences were 84 and 100 % sensitivity, 67 and 56 % specificity, 88 and 86 % PPV, and 60 and 100 % NPV, respectively.Multi-modal imaging assessment of co-registered MRI and PET/CT images provides more accurate results for trans-compartmental extensions in T and N staging than the individual techniques alone.