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The value of 18F-fluorodeoxyglucose-positron emission tomography/ computed tomography (18F- FDG PET/CT) in the staging and impact on the management of patients with nasopharyngeal carcinoma

Sethu Thakachy Subha, Fathinul Fikri Ahmad Saad, Abdul Jalil Nordin and Saraiza Abu Bakar

Pertanika Journal of Tropical Agricultural Science, Volume 25, Issue 3, July 2017

Keywords: 18F-FDG PET/CT, nasopharyngeal carcinoma, AJCC-TNM staging), SUVmax, impact

Published on: 20 Jun 2017

This study sought to prospectively evaluate the influence of contrasted fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDGPET/CT) in the staging of and impact on the management plan for treatment in patients with nasopharyngeal carcinoma (NPC). A total of 14 histologically proven NPC patients (mean age: 44.64±4.01years) were included in the study. These patients underwent contrasted Computed Tomography (CT) as well as 18F-FDGPET/CT imaging. Staging was based on the 7th edition of the American Joint Committee on Cancer Tumor Node Metastases (AJCC-TNM) recommendations. The oncologist was asked to prospectively assign a treatment plan for all patients being evaluated by CT and 18F-FDGPET/CT. The treatment plans were compared with the incremental information supplied by the FDG-PET/CT. The maximum standardised uptake value (SUVmax) and the widest dimension of the primary tumour, cervical lymph nodes size and the distant metastatic lesions were quantified on the co-registered PET/CT images by two experienced nuclear radiologists. The contrasted 18F-FDGPET/CT changed the management intent in nine patients (64.7%). A univariate analysis showed that there were significant correlations between SUVmax and the size of the metastatic lymph nodes (R2 =0.0761, p<0.01), lymph node volume (R2=0.695, p<0.01) and the T-stage (R2=0.647, p<0.01). Multiple linear regression analysis revealed the tumour SUVmax to be the independent predictor of the T-stage (adjusted R2=0.889, p<0.05). The SUVmax may potentially be a surrogate marker for the T-stage in the NPC patients. The use of the combined imaging modality, 18F-FDGPET/CT, substantially impacted on the management strategy for treatment of NPC patients.

ISSN 1511-3701

e-ISSN 2231-8542

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