18F-FDG PET Can Replace Conventional Work-up in Primary M Staging of Nonkeratinizing Nasopharyngeal Carcinoma

F.-Y. Liu, C.-Y. Lin, J. T. Chang, S.-H. Ng, S.-C. Chin, H.-M. Wang, C.-T. Liao, S.-C. Chan, T.-C. Yen
2007 Journal of Nuclear Medicine  
Conventional work-up (CWU) with chest radiography, abdominal ultrasonography, and skeletal scintigraphy has limited value in M staging of nonkeratinizing nasopharyngeal carcinoma (NPC). Our aim was to evaluate whether 18 F-FDG PET could replace CWU by comparing their diagnostic efficacies. Methods: Patients with histologically proven nonkeratinizing NPC and no prior treatment were prospectively enrolled. All study participants underwent CWU and 18 F-FDG PET for primary M staging. Distant
more » ... sis was considered to be present if there was any reliable evidence identified within 1 y after diagnosis. The comparative diagnostic efficacies of 18 F-FDG PET, CWU, and the combination of 18 F-FDG PET and CWU (PET1CWU) were evaluated using the areas under the receiver-operating-characteristic (ROC) curves. Results: Sixty-one (20.3%) of 300 eligible patients were found to have distant metastases. On a patient-based analysis, 18 F-FDG PET was found to be more effective than CWU (P , 0.001), whereas it was equally effective with PET1CWU (P 5 0.130). On region-based analyses, 18 F-FDG PET was more effective than skeletal scintigraphy and chest radiography for detecting bone metastases (P , 0.001) and chest metastases (P , 0.001), respectively. 18 F-FDG PET and abdominal ultrasound were equally effective for detecting hepatic metastases (P 5 0.127). On region-based analyses, the combination of 18 F-FDG PET and CWU did not yield any noticeable increase in diagnostic efficacy. Conclusion: 18 F-FDG PET can replace CWU in primary M staging of nonkeratinizing NPC.
doi:10.2967/jnumed.107.043406 pmid:17873135 fatcat:fi7aeuxdl5g6dbrzmwpo4svs6a