Shen Yilin, Wu Jichang, Shen Chenling, Huang Xinyun, Fan Cui, Hu Haixia, Cheng Zenghui, Li Biao, Xiang Mingliang, Ye Bin
Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, China.
Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Diagnostics (Basel). 2025 Apr 24;15(9):1081. doi: 10.3390/diagnostics15091081.
Oropharyngeal carcinoma is experiencing an increase in incidence and can easily metastasize to the cervical lymph nodes. Therefore, evaluating the tumor boundary and lymph node metastasis before treatment is critical. Both CT and MR may have limitations in describing the specific boundaries of oropharyngeal tumors. To date, no research has applied PET/MR imaging to patients with only oropharyngeal carcinoma and verified its diagnostic value. The aim of our study was to evaluate the diagnostic value of PET/MR in patients with oropharyngeal carcinoma. We prepared PET/MR for comparison with CT/MR for T and N staging, with the aim of exploring the relationship between the imaging parameters and different biological factors. This was a retrospective, observational study. In total, 13 patients (11 males and 2 females) with oropharyngeal tumors who underwent FDG PET/MR and enhanced CT/MR from July 2021 to December 2022 were retrospectively analyzed. Cohen's kappa coefficient and the McNemar test were used to compare the consistencies and diagnostic values of FDG PET/MR and enhanced CT/MR imaging in relation to primary tumors and cervical lymph node metastases. Various specific parameters of FDG PET/MR were included in the statistics. Spearman correlation coefficients were used to analyze the relationship between the parameters and the tumor stage, the degree of differentiation, p16 expression, Ki67 expression, and serological tumor markers. : The average age of the patients was 61.54 ± 6.62 years old. Preoperative imaging demonstrated good consistency between FDG PET/MR and enhanced CT and MR for the diagnosis of clinical T stage. A total of seven patients underwent surgery directly. Overall, 231 cervical lymph nodes were dissected. Compared to the postoperative histopathological results, PET/MR was significantly more sensitive than enhanced CT/MR imaging (78.57% vs. 50.00%, < 0.05; 78.57% vs. 64.29%, < 0.05, respectively). Also, PET/MR showed more accuracy in diagnosing metastatic lymph nodes, but without significance. Combined with PET/MR-specific parameters, the SUV, TLG, and the MTV were found to be higher in the patients with more advanced stages of cancer and lower in those with p16-positive tumors. In addition, they were found to be positively correlated with the level of serum CEA. This is the first study to evaluate the clinical diagnostic value of PET/MR in patients with oropharyngeal carcinoma. We believe that PET/MR has more advantages in describing tumor boundaries. It is more sensitive or even more accurate for the evaluation of metastatic cervical lymph nodes.
口咽癌的发病率正在上升，且容易转移至颈部淋巴结。因此，在治疗前评估肿瘤边界和淋巴结转移情况至关重要。CT和MR在描述口咽肿瘤的具体边界方面可能都存在局限性。迄今为止，尚无研究将PET/MR成像应用于仅患有口咽癌的患者并验证其诊断价值。我们研究的目的是评估PET/MR在口咽癌患者中的诊断价值。我们准备了PET/MR以与CT/MR进行比较，用于T和N分期，旨在探索成像参数与不同生物学因素之间的关系。这是一项回顾性观察研究。总共对2021年7月至2022年12月期间接受FDG PET/MR及增强CT/MR检查的13例口咽肿瘤患者（11例男性和2例女性）进行了回顾性分析。使用Cohen's kappa系数和McNemar检验来比较FDG PET/MR与增强CT/MR成像在原发性肿瘤和颈部淋巴结转移方面的一致性和诊断价值。将FDG PET/MR的各种特定参数纳入统计分析。使用Spearman相关系数分析这些参数与肿瘤分期、分化程度、p16表达、Ki67表达及血清肿瘤标志物之间的关系。患者的平均年龄为61.54±6.62岁。术前成像显示FDG PET/MR与增强CT及MR在临床T分期诊断方面具有良好的一致性。共有7例患者直接接受了手术。总共清扫了231个颈部淋巴结。与术后组织病理学结果相比，PET/MR比增强CT/MR成像明显更敏感（分别为78.57%对50.00%，P<0.05；78.57%对64.29%，P<0.05）。此外，PET/MR在诊断转移淋巴结方面显示出更高的准确性，但无统计学意义。结合PET/MR的特定参数，发现SUV、TLG和MTV在癌症分期较晚的患者中较高，而在p16阳性肿瘤患者中较低。此外，发现它们与血清CEA水平呈正相关。这是第一项评估PET/MR在口咽癌患者中临床诊断价值的研究。我们认为PET/MR在描述肿瘤边界方面具有更多优势。它在评估颈部转移淋巴结方面更敏感甚至更准确。
