Assessment of bone lesions with 18F-FDG PET/MRI in patients with nasopharyngeal carcinoma.

PURPOSE: The purpose of this study is to evaluate the role of 18 fluorodeoxyglucose (18F) PET/MRI (18F-FDG PET/MRI) for detecting bone metastasis in nasopharyngeal carcinoma (NPC).

PATIENTS AND METHODS: Between May 2017 and May 2021, 58 histologically proven NPC patients who underwent both 18F-FDG PET/MRI and 99mTc-MDP planar bone scintigraphy (PBS) for tumor staging were included. With the exception of the head, the skeletal system was classified into four groups: the spine, the pelvis, the thorax and the appendix.

RESULTS: Nine (15.5 %) of 58 patients were confirmed to have bone metastasis. There was no statistical difference between PET/MRI and PBS in patient-based analysis (P = 0.125). One patient with a super scan was confirmed to have extensive and diffuse bone metastases and excluded for lesion-based analysis. Of the 57 patients, all 48 true metastatic lesions were positive in PET/MRI whereas only 24 true metastatic lesions were positive in PBS (spine: 8, thorax: 0, pelvis: 11 and appendix: 5). PET/MRI was observed to be more sensitive than PBS in lesion-based analysis (sensitivity 100.0% versus 50.0 %; P < 0.001).

CONCLUSIONS: Compared with PBS for tumor staging of NPC, PET/MRI was observed to be more sensitive in the lesion-based analysis of bone metastasis.