[Clinical application of (18)F-FDG PET/CT to staging and treatment effectiveness monitoring of nasopharyngeal carcinoma].

BACKGROUND & OBJECTIVE: Fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET/CT could increase the accuracy of diagnosis, staging, and treatment effectiveness monitoring of many malignant diseases, such as lung cancer and esophageal cancer. This study was to evaluate the clinical application of (18)F-FDG PET/CT to the staging, restaging, and treatment effectiveness monitoring of nasopharyngeal carcinoma (NPC).

METHODS: The reports of whole body (18)F-FDG PET/CT scans, performed from Feb. 2002 to Dec. 2005 on 43 NPC patients (26 men and 17 women with median age of 52 years) in Peter MacCallum Cancer Center, were reviewed. The final diagnoses were made according to medical records, pathologic reports and follow-up information. The accuracy, specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of (18)F-FDG PET/CT, CT and MRI were calculated and analyzed.

RESULTS: The accuracy, specificity, sensitivity, PPV, and NPV of (18)F-FDG PET/CT were 95.3%, 100.0%, 85.7%, 93.8%, and 100.0%, respectively; those of CT and MRI were 65.5%, 79.4%, 64.7%, 81.8%, and 57.9%, respectively. The results of (18)F-FDG PET/CT led to changes in the medical management of 2 staged patients, and 7 restaged patients and 5 patients in monitoring group. (18)F-FDG PET/CT scan affected the therapy plan of 3 restaged patients and 11 patients in monitoring group. Two cases of second primary malignancies(1 case of thyroid carcinoma and 1 case of low grade gastric carcinoma) were detected by (18)F-FDG PET/CT scan.

CONCLUSION: (18)F-FDG PET/CT is better than conventional imaging in N and M staging and treatment effectiveness monitoring of NPC.