Fan Cui, Huang Xinyun, Wang Hao, Hu Haixia, Wu Jichang, Miao Xiangwan, Liu Yuenan, Xiang Mingliang, Chen Nijun, Ye Bin
Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Road, Shanghai 200025, China.
Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China.
Diagnostics (Basel). 2025 Aug 22;15(17):2119. doi: 10.3390/diagnostics15172119.
To evaluate the diagnostic performance of fluorine 18 fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (F-FDG PET/MR) in the preoperative staging of hypopharyngeal cancer (HPC), compare it with conventional enhanced computed tomography (CT) and MR, and further explore the prognostic value of its metabolic and diffusion metrics for HPC. This retrospective study included 33 patients with pathologically confirmed HPC. All patients underwent preoperative F-FDG PET/MR, CT, and MR examination. The staging performance of the three modalities was evaluated using pathological staging as a reference. Additionally, metabolic indicators and diffusion-related parameters from PET/MR were collected to investigate their impact on larynx preservation and survival. PET/MR demonstrated accuracies of 90.9% and 71.4% in the preoperative T and N staging, respectively, significantly higher than those of CT (54.5%, = 0.001; 42.9%, = 0.021) and MR (66.7%, = 0.016; 42.9%, = 0.021). On the whole, significant differences emerged in the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), minimum apparent diffusion coefficient (ADCmin), and mean ADC (ADCmean) and combined ratios across different T stages, while SUVmax, mean SUV (SUVmean), total lesion glycolysis (TLG), and MTV varied significantly across different N stages. The ADCmin and ADCmean showed good predictive capability for larynx preservation, with AUCs of 0.857 and 0.920 ( < 0.05), respectively. In Cox multivariate analysis of overall survival, high-level ADCmean ( 0.004) and low-level TLG/ADCmean ( = 0.022) were significantly associated with better survival. In HPC, F-FDG PET/MR imaging significantly surpasses CT and MR in preoperative diagnostic staging. Its diffusion-related parameters have substantial prognostic value, with high ADC values associated with larynx preservation. ADCmean and TLG/ADCmean are potential prognostic indicators for HPC.
为评估氟代脱氧葡萄糖正电子发射断层扫描/磁共振成像（F-FDG PET/MR）在下咽癌（HPC）术前分期中的诊断性能，将其与传统增强计算机断层扫描（CT）和磁共振成像（MR）进行比较，并进一步探讨其代谢和扩散指标对HPC的预后价值。这项回顾性研究纳入了33例经病理证实的HPC患者。所有患者均接受了术前F-FDG PET/MR、CT和MR检查。以病理分期为参照评估这三种检查方式的分期性能。此外，收集PET/MR的代谢指标和扩散相关参数，以研究它们对喉保留和生存的影响。PET/MR在术前T分期和N分期中的准确率分别为90.9%和71.4%，显著高于CT（54.5%，P = 0.001；42.9%，P = 0.021）和MR（66.7%，P = 0.016；42.9%，P = 0.021）。总体而言，不同T分期的最大标准摄取值（SUVmax）、代谢肿瘤体积（MTV）、最小表观扩散系数（ADCmin）、平均表观扩散系数（ADCmean）及联合比值存在显著差异，而不同N分期的SUVmax、平均标准摄取值（SUVmean）、总病变糖酵解（TLG）和MTV有显著变化。ADCmin和ADCmean对喉保留显示出良好的预测能力，曲线下面积（AUC）分别为0.857和0.920（P < 0.05）。在总生存的Cox多因素分析中，高水平的ADCmean（P = 0.004）和低水平的TLG/ADCmean（P = 0.022）与更好的生存显著相关。在HPC中，F-FDG PET/MR成像在术前诊断分期方面显著优于CT和MR。其扩散相关参数具有重要的预后价值，高ADC值与喉保留相关。ADCmean和TLG/ADCmean是HPC潜在的预后指标。
