Schlittenbauer Tilo, Zeilinger Martin, Nkenke Emeka, Kreißel Sebastian, Wurm Matthias C, Lell Michael, Kuwert Torsten, Beck Michael
Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. F.W. Neukam), University of Erlangen-Nürnberg, Erlangen, Germany.
Department of Radiology, University of Erlangen-Nürnberg, Erlangen, Germany.
J Craniomaxillofac Surg. 2015 Dec;43(10):2129-35. doi: 10.1016/j.jcms.2015.08.030. Epub 2015 Sep 11.
Diagnostic imaging of head and neck cancer has made enormous progress during recent years. Next to morphological imaging modalities (computed tomography [CT] and magnetic resonance imaging [MRI]), there are also hybrid imaging systems that combine functional and morphological information (positron emission tomography [PET]/CT and PET/MRI). The aim of this study was to compare the diagnostic accuracy of PET/MRI in the diagnosis of head and neck cancer with other imaging modalities (MRI, CT, PET/CT). Ten patients (nine male and one female) with histologically proven oral squamous cell carcinoma participated in an 18 F-FDG-PET/CT scan and an additional 18 F-FDG PET/MRI scan prior to surgery. The morphological and functional results were compared with the histological results. Inclusion criteria were histologically proven oral squamous cell carcinoma and no prior surgical intervention, medical therapy, or local external radiation. There was no significant correlation between tumor differentiation and maximum standard uptake values. Functional imaging showed a slightly better correlation with the measurement of the maximal tumor diameter, whereas pure morphological imaging showed a better correlation with the measurement of infiltration depth. Only with PET/MRI could correct lymph node staging be reached; the other imaging tools showed false-negative or false-positive results. In conclusion, we showed in our limited patient cohort that PET/MRI is superior to the morphological imaging modalities, especially for lymph node staging.
近年来,头颈部癌的诊断成像取得了巨大进展。除了形态学成像方式(计算机断层扫描[CT]和磁共振成像[MRI])外,还有结合功能和形态学信息的混合成像系统(正电子发射断层扫描[PET]/CT和PET/MRI)。本研究的目的是比较PET/MRI在头颈部癌诊断中的诊断准确性与其他成像方式(MRI、CT、PET/CT)。10例经组织学证实为口腔鳞状细胞癌的患者(9例男性,1例女性)在手术前接受了18F-FDG-PET/CT扫描和额外的18F-FDG PET/MRI扫描。将形态学和功能学结果与组织学结果进行比较。纳入标准为经组织学证实的口腔鳞状细胞癌,且既往无手术干预、药物治疗或局部外照射。肿瘤分化与最大标准摄取值之间无显著相关性。功能成像与最大肿瘤直径的测量显示出稍好的相关性,而单纯形态学成像与浸润深度的测量显示出更好的相关性。只有PET/MRI能够实现正确的淋巴结分期;其他成像工具显示出假阴性或假阳性结果。总之,我们在有限的患者队列中表明,PET/MRI优于形态学成像方式,尤其是在淋巴结分期方面。