PET/MR for predicting extranodal extension of head and neck cancer

被引:0
作者
Sanchez, Vanessa [1 ]
Pizzuto, Daniele A. [1 ,2 ]
Maurer, Alexander [1 ]
Muehlematter, Urs J. [1 ]
Sah, Bert-Ram [1 ,3 ]
Husmann, Lars [1 ]
Skawran, Stephan [1 ,4 ]
Mader, Caecilia E. [1 ]
Morand, Gregoire B. [5 ]
Mueller, Simon A. [5 ]
Meerwein, Christian [5 ]
Rupp, Niels J. [6 ]
Freiberger, Sandra [6 ]
Lanzer, Martin [7 ]
Messerli, Michael [1 ]
Huellner, Martin W. [1 ]
机构
[1] Univ Zurich, Univ Hosp Zurich, Dept Nucl Med, Zurich, Switzerland
[2] Fdn Policlin Univ Agostino Gemelli IRCCS, Nucl Med Unit, GSteP Radiopharm, Rome, Italy
[3] Univ Bern, Univ Hosp Bern, Dept Diagnost Intervent & Pediat Radiol, Inselspital, Bern, Switzerland
[4] Tech Univ Munich, Univ Hosp Rechts Isar, Dept Nucl Med, Munich, Germany
[5] Univ Zurich, Univ Hosp Zurich, Dept Otorhinolaryngol Head & Neck Surg, Zurich, Switzerland
[6] Univ Zurich, Univ Hosp Zurich, Dept Pathol & Mol Pathol, Zurich, Switzerland
[7] Univ Zurich, Univ Hosp Zurich, Dept Cranio Maxillo Facial & Oral Surg, Zurich, Switzerland
关键词
PET/MR; Head and neck cancer; Hybrid imaging; Extranodal extension; 2-[18F]-fluorodeoxy-D-glucose; SQUAMOUS-CELL CARCINOMA; PROGNOSTIC VALUE; FDG-PET/CT; SPREAD; CHEMOTHERAPY;
D O I
10.1007/s00234-025-03635-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose To analyze the diagnostic accuracy of multiparametric FDG-PET/MR in identifying pathologic extranodal extension (pENE) of lymph node metastases (LNM) in head and neck squamous cell carcinoma (HNSCC) patients. Methods and materials Retrospective analysis of 57 HNSCC patients who underwent preoperative FDG-PET/MR imaging. PET parameters of LNM SUVmax and MTV, lymph node size as well as MR parameters flare sign, shaggy margin sign and vanishing border sign were analyzed. Histopathological assessment of neck dissection specimens served as standard of reference. Results A logistic regression model consisting of lymph node size (p = 0.029), shaggy margin sign (p = 0.031) and MTV (p = 0.035) proved that all three parameters significantly contributed to the prediction of pENE (chi(2)(3) = 54.23, p < 0.001). A second model without the reader-dependent parameter shaggy margin sign yielded similar results (chi(2)(2) = 45.36, p < 0.001), with every increase in lymph node size (p = 0.006) by 1 mm increasing the likelihood of pENE by a factor of 1.41 (95%-CI[1.11, 1.81]), and every increase in MTV (p = 0.023) by 1 cm3 increasing the likelihood of pENE by a factor of 1.64 (95%-CI[1.07, 2.50]). This model yielded an accuracy of 94.7% (95%-CI [85.4, 98.9]) for predicting pENE, with a specificity of 97.3% (95%-CI [85.8, 99.9]) and a sensitivity of 90.0% (95%-CI [68.3, 98.8]). Internal validation using a test dataset confirmed high accuracy of this model. Conclusion PET/MR-based multivariate binomial logistic regression models consisting of MTV, lymph node size and/or shaggy lymph node margins predict pENE with high accuracy.
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页数:10
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