Detection of distant metastases and distant second primary cancers in head and neck squamous cell carcinoma: comparison of [18F]FDG PET/MRI and [18F]FDG PET/CT

Eirini Katirtzidou , Olivier Rager , Arthur Damien Varoquaux (1, 2) , Antoine Poncet , Vincent Lenoir , Nicolas Dulguerov , Alexandra Platon , Valentina Garibotto , Habib Zaidi , Minerva Becker

1 CRMBM - Centre de résonance magnétique biologique et médicale
2 TIMONE - Hôpital de la Timone [CHU - APHM]

Purpose This prospective study aimed to compare the diagnostic performance of [ 18 ]FDG PET/MRI and PET/CT for the detection of distant metastases and distant second primary cancers in patients with head and neck squamous cell carcinoma (HNSCC). Methods A total of 103 [ 18 F]FDG PET/MRI examinations immediately followed by PET/CT were obtained in 82 consecutive patients for staging of primary HNSCC ( n = 38), suspected loco-regional recurrence/follow-up ( n = 41) or unknown primary HNSCC ( n = 3). Histology and follow-up > 2 years formed the standard of reference. Blinded readers evaluated the anonymized PET/MRI and PET/CT examinations separately using a 5-point Likert score. Statistical analysis included: receiver operating characteristic (ROC) analysis, jackknife alternative free-response ROC (JAFROC) and region-of-interest (ROI)-based ROC to account for data clustering and sensitivity/specificity/accuracy comparisons for a score ≥ 3. Results Distant metastases and distant second primary cancers were present in 23/103 (22%) examinations in 16/82 (19.5%) patients, and they were more common in the post-treatment group (11/41, 27%) than in the primary HNSCC group (3/38, 8%), p = 0.039. The area under the curve (AUC) per patient/examination/lesion was 0.947 [0.927–1]/0.965 [0.917–1]/0.957 [0.928–0.987] for PET/MRI and 0.975 [0.950–1]/0.968 [0.920–1]/0.944 [0.910–0.979] for PET/CT, respectively ( p > 0.05). The diagnostic performance of PET/MRI and PET/CT was similar according to JAFROC ( p = 0.919) and ROI-based ROC analysis ( p = 0.574). Sensitivity/specificity/accuracy for PET/MRI and PET/CT for a score ≥ 3 was 94%/88%/89% and 94%/91%/91% per patient, 96%/90%/91% and 96%/93%/93% per examination and 95%/85%/90% and 90%/86%/88% per lesion, respectively, p > 0.05. Conclusions In HNSCC patients, PET/MRI and PET/CT had a high and similar diagnostic performance for detecting distant metastases and distant second primary cancers.

Mots clés: PET/MRI; PET/CT; Head and neck tumors; Metastases; Second primary cancer

Domaines: Médecine humaine et pathologie

Eirini Katirtzidou, Olivier Rager, Arthur Damien Varoquaux, Antoine Poncet, Vincent Lenoir, et al.. Detection of distant metastases and distant second primary cancers in head and neck squamous cell carcinoma: comparison of [18F]FDG PET/MRI and [18F]FDG PET/CT. Insights into Imaging, 2022, 13 (1), pp.121. ⟨10.1186/s13244-022-01261-0⟩. ⟨hal-04009123⟩