Clinical values of 18FDG PET-CT and MRI in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma

2017 
Objective To investigate the clinical values of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET-CT) and magnetic resonance imaging (MRI) in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma. Methods A total of 53 patients with oropharyngeal squamous cell carcinoma were enrolled and underwent PET-CT and MRI imaging within two weeks after surgery. The detection rates of residual lesions and lymph node metastases after surgery by PET-CT and MRI were compared on the basis of the pathological results of biopsy. The gross tumor volume (GTV) and clinical target volume (CTV) determined by PET-CT and MRI were compared; the normally distributed data were analyzed using the t test, and the skewed distribution data by the Wilcoxon rank sum test. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in predicting precise radiotherapy after surgery, as determined by PET-CT and MRI, were compared with the chi-square test. Results Fourteen patients had residual lesions after surgery. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET-CT in detecting residual lesions after surgery were significantly higher than those of MRI (92.86%, 94.87%, 86.67%, 97.37%, and 94.34% vs. 57.14%, 76.92%, 47.06%, 83.34%, and 71.70%, all P 0.05). For the 14 patients with residual lesions, GTVPET/CT was significantly smaller than GTVMRI(45.62±22.13 cm3vs. 60.61±23.12 cm3,P=0.034), so did CTV (125.54±17.53 cm3vs. 142.18±21.22 cm3,P=0.011). There was no significant difference between CTVPET-CT and CTVMRI in 39 patients without residual lesions after surgery (117.87±17.66 cm3vs. 128.05±20.65, P=0.099). Conclusions PET-CT is superior to MRI in detecting the residual lesions and lymph node metastases after surgery in patients with oropharyngeal squamous cell carcinoma, which provides valuable information for radiotherapy planning. Key words: Oropharyngeal neoplasms/radiotherapy; Contrastive analysis; Radiomics
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