Multimodal Imaging With Positron Emission Tomography/Computed Tomography and Magnetic Resonance Imaging to Detect Extracapsular Extension in Head and Neck Cancer.

Sheppard, Sean C.; Giger, Roland; Bojaxhiu, Beat; Sachpekidis, Christos; Dammann, Florian; Dettmer, Matthias S.; Arnold, Andreas Michael; Wartenberg, Jan Peter Arnold; Nisa, Lluís (2021). Multimodal Imaging With Positron Emission Tomography/Computed Tomography and Magnetic Resonance Imaging to Detect Extracapsular Extension in Head and Neck Cancer. The Laryngoscope, 131(1), E163-E169. Wiley 10.1002/lary.28602

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OBJECTIVES/HYPOTHESIS

To assess the ability of specific positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) features to detect extracapsular extension (ECE) in head and neck squamous cell carcinoma (HNSCC) patients.

STUDY DESIGN

Retrospective study in a tertiary certified university cancer institute.

METHODS

We performed a review of patients with advanced HNSCC at Bern University Hospital between 2014 and 2018. Patients with pretherapeutic PET/CT and/or MRI who underwent neck dissection were included, with 212 patients fulfilling inclusion criteria. Blinded evaluation of specific PET/CT and MRI features with respect to presence of ECE was performed. Histopathological examination of neck dissection specimens was used as the gold standard to determine ECE status.

RESULTS

Out of the 212 included patients, 184 had PET/CT, 186 MRI, and 158 both modalities. Overall clinical stage IV (odds ratio [OR]: 2.26, 95% confidence interval [CI]: 2.25-11.74), ill-defined margins in both PET/CT and MRI (OR: 3.48, 95% CI: 1.21-9.98 and OR: 2.14, 95% CI: 0.94-4.89, respectively), and a maximum standardized uptake value ≥ 10 (OR: 5.44, 95% CI: 1.21-9.98) were all significant independent predictors of ECE. When combined, these four features led to a cumulative score able to predict ECE status with an accuracy of 91.43%.

CONCLUSIONS

The current findings indicate specific features in PET/CT and MRI are potential predictors of ECE status and may help in pretherapeutic stratification in HNSCC.

LEVEL OF EVIDENCE

4 Laryngoscope, 2020.

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5 Citations in Web of Science ®
6 Citations in Scopus

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