Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal Carcinoma

<b>Objectives:</b> Oropharyngeal carcinoma is experiencing an increase in incidence and can easily metastasize to the cervical lymph nodes. Therefore, evaluating the tumor boundary and lymph node metastasis before treatment is critical. Both CT and MR may have limitations in describing t...

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Main Authors: Yilin Shen, Jichang Wu, Chenling Shen, Xinyun Huang, Cui Fan, Haixia Hu, Zenghui Cheng, Biao Li, Mingliang Xiang, Bin Ye
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/9/1081
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author Yilin Shen
Jichang Wu
Chenling Shen
Xinyun Huang
Cui Fan
Haixia Hu
Zenghui Cheng
Biao Li
Mingliang Xiang
Bin Ye
author_facet Yilin Shen
Jichang Wu
Chenling Shen
Xinyun Huang
Cui Fan
Haixia Hu
Zenghui Cheng
Biao Li
Mingliang Xiang
Bin Ye
author_sort Yilin Shen
collection DOAJ
description <b>Objectives:</b> Oropharyngeal carcinoma is experiencing an increase in incidence and can easily metastasize to the cervical lymph nodes. Therefore, evaluating the tumor boundary and lymph node metastasis before treatment is critical. Both CT and MR may have limitations in describing the specific boundaries of oropharyngeal tumors. To date, no research has applied PET/MR imaging to patients with only oropharyngeal carcinoma and verified its diagnostic value. The aim of our study was to evaluate the diagnostic value of PET/MR in patients with oropharyngeal carcinoma. We prepared PET/MR for comparison with CT/MR for T and N staging, with the aim of exploring the relationship between the imaging parameters and different biological factors. <b>Methods:</b> This was a retrospective, observational study. In total, 13 patients (11 males and 2 females) with oropharyngeal tumors who underwent FDG PET/MR and enhanced CT/MR from July 2021 to December 2022 were retrospectively analyzed. Cohen’s kappa coefficient and the McNemar test were used to compare the consistencies and diagnostic values of FDG PET/MR and enhanced CT/MR imaging in relation to primary tumors and cervical lymph node metastases. Various specific parameters of FDG PET/MR were included in the statistics. Spearman correlation coefficients were used to analyze the relationship between the parameters and the tumor stage, the degree of differentiation, p16 expression, Ki67 expression, and serological tumor markers. <b>Results</b>: The average age of the patients was 61.54 ± 6.62 years old. Preoperative imaging demonstrated good consistency between FDG PET/MR and enhanced CT and MR for the diagnosis of clinical T stage. A total of seven patients underwent surgery directly. Overall, 231 cervical lymph nodes were dissected. Compared to the postoperative histopathological results, PET/MR was significantly more sensitive than enhanced CT/MR imaging (78.57% vs. 50.00%, <i>p</i> < 0.05; 78.57% vs. 64.29%, <i>p</i> < 0.05, respectively). Also, PET/MR showed more accuracy in diagnosing metastatic lymph nodes, but without significance. Combined with PET/MR-specific parameters, the SUV, TLG, and the MTV were found to be higher in the patients with more advanced stages of cancer and lower in those with p16-positive tumors. In addition, they were found to be positively correlated with the level of serum CEA. <b>Conclusions:</b> This is the first study to evaluate the clinical diagnostic value of PET/MR in patients with oropharyngeal carcinoma. We believe that PET/MR has more advantages in describing tumor boundaries. It is more sensitive or even more accurate for the evaluation of metastatic cervical lymph nodes.
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spelling doaj-art-62068295ed5b4ae1aeaee9a53ee5ae3a2025-08-20T03:49:22ZengMDPI AGDiagnostics2075-44182025-04-01159108110.3390/diagnostics15091081Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal CarcinomaYilin Shen0Jichang Wu1Chenling Shen2Xinyun Huang3Cui Fan4Haixia Hu5Zenghui Cheng6Biao Li7Mingliang Xiang8Bin Ye9Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, ChinaDepartment of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, ChinaDepartment of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, ChinaDepartment of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaDepartment of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, ChinaDepartment of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, ChinaDepartment of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaDepartment of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaDepartment of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, ChinaDepartment of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200070, China<b>Objectives:</b> Oropharyngeal carcinoma is experiencing an increase in incidence and can easily metastasize to the cervical lymph nodes. Therefore, evaluating the tumor boundary and lymph node metastasis before treatment is critical. Both CT and MR may have limitations in describing the specific boundaries of oropharyngeal tumors. To date, no research has applied PET/MR imaging to patients with only oropharyngeal carcinoma and verified its diagnostic value. The aim of our study was to evaluate the diagnostic value of PET/MR in patients with oropharyngeal carcinoma. We prepared PET/MR for comparison with CT/MR for T and N staging, with the aim of exploring the relationship between the imaging parameters and different biological factors. <b>Methods:</b> This was a retrospective, observational study. In total, 13 patients (11 males and 2 females) with oropharyngeal tumors who underwent FDG PET/MR and enhanced CT/MR from July 2021 to December 2022 were retrospectively analyzed. Cohen’s kappa coefficient and the McNemar test were used to compare the consistencies and diagnostic values of FDG PET/MR and enhanced CT/MR imaging in relation to primary tumors and cervical lymph node metastases. Various specific parameters of FDG PET/MR were included in the statistics. Spearman correlation coefficients were used to analyze the relationship between the parameters and the tumor stage, the degree of differentiation, p16 expression, Ki67 expression, and serological tumor markers. <b>Results</b>: The average age of the patients was 61.54 ± 6.62 years old. Preoperative imaging demonstrated good consistency between FDG PET/MR and enhanced CT and MR for the diagnosis of clinical T stage. A total of seven patients underwent surgery directly. Overall, 231 cervical lymph nodes were dissected. Compared to the postoperative histopathological results, PET/MR was significantly more sensitive than enhanced CT/MR imaging (78.57% vs. 50.00%, <i>p</i> < 0.05; 78.57% vs. 64.29%, <i>p</i> < 0.05, respectively). Also, PET/MR showed more accuracy in diagnosing metastatic lymph nodes, but without significance. Combined with PET/MR-specific parameters, the SUV, TLG, and the MTV were found to be higher in the patients with more advanced stages of cancer and lower in those with p16-positive tumors. In addition, they were found to be positively correlated with the level of serum CEA. <b>Conclusions:</b> This is the first study to evaluate the clinical diagnostic value of PET/MR in patients with oropharyngeal carcinoma. We believe that PET/MR has more advantages in describing tumor boundaries. It is more sensitive or even more accurate for the evaluation of metastatic cervical lymph nodes.https://www.mdpi.com/2075-4418/15/9/1081oropharyngeal carcinomatonsil carcinomaFDG PET/MRcervical lymph node metastases
spellingShingle Yilin Shen
Jichang Wu
Chenling Shen
Xinyun Huang
Cui Fan
Haixia Hu
Zenghui Cheng
Biao Li
Mingliang Xiang
Bin Ye
Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal Carcinoma
Diagnostics
oropharyngeal carcinoma
tonsil carcinoma
FDG PET/MR
cervical lymph node metastases
title Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal Carcinoma
title_full Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal Carcinoma
title_fullStr Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal Carcinoma
title_full_unstemmed Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal Carcinoma
title_short Application of <sup>18</sup>F-FDG Positron Emission Tomography/Magnetic Resonance in Evaluation of Oropharyngeal Carcinoma
title_sort application of sup 18 sup f fdg positron emission tomography magnetic resonance in evaluation of oropharyngeal carcinoma
topic oropharyngeal carcinoma
tonsil carcinoma
FDG PET/MR
cervical lymph node metastases
url https://www.mdpi.com/2075-4418/15/9/1081
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