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. 2015 Jan 15;5(2):154-61.
eCollection 2015.

Imaging modality utilization trends in patients with stage III-IV oropharyngeal squamous cell carcinoma

Yukako Ichimiya  1 , Krishna Alluri  1 , Charles Marcus  1 , Simon Best  2 , Christine H Chung  3 , Rathan M Subramaniam  4
Affiliations

Imaging modality utilization trends in patients with stage III-IV oropharyngeal squamous cell carcinoma

Yukako Ichimiya et al. Am J Nucl Med Mol Imaging. .

Abstract

The objective of this study is to establish the utilization trends of CT, MRI, and FDG-PET/CT for evaluation of oropharyngeal squamous cell carcinoma (OPSCC) patients. A total of 173 patients with newly diagnosed stage III or IV OPSCC between 2003 and 2009 were included. Frequency of imaging modality use, divided into four time periods (2003-04, 2005-06, 2007-08 and 2009), was evaluated. For initial staging, percentage of PET/CT use was 64.6%, 87.5%, 94.1% and 96.3%, with an increasing trend (p < 0.001). The CT (p = 0.762) and MRI (p = 0.224) use demonstrated no change in trend. For post-treatment imaging, percentage of PET/CT use was 59.5%, 68.6%, 89.7% and 100%, with an increasing trend (p < 0.001). The CT use demonstrated a decreasing trend (p = 0.004) and MRI showed no trend change (p = 0.231). PET/CT is used with an increasing trend for initial staging and has become a central imaging modality for follow up evaluation after treatment, for advanced OPSCC.

Keywords: FDG; Oropharyngeal squamous cell carcinoma (OPSCC); PET/CT; cancer; magnetic resonance imaging (MRI).

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Figures

Figure 1
Figure 1
Percentage of imaging modalities used at initial staging (n = 173).
Figure 2
Figure 2
A: Percentage of imaging modalities used at initial staging in patients who received radiation therapy (n = 96). B: Percentage of imaging modalities used at initial staging in patients treated with Surgery (n = 70).
Figure 3
Figure 3
Percentage of imaging modalities used post-treatment (n = 148).
Figure 4
Figure 4
A: Percentage of imaging modalities used post-treatment in patients received radiation therapy (n = 96). B: Percentage of imaging modalities used post-treatment in patients treated with surgery (n = 70).
Figure 5
Figure 5
Value of contrast enhanced FDG PET/CT- Axial PET (A), fused PET/CT (B), contrast enhanced CT (C) images of a 60 year old gentleman with HPV associated squamous cell carcinoma of the tongue base who underwent a staging FDG PET/CT study. PET/CT shows hypermetabolic base of tongue mass (SUVmax – 4.6), hypermetabolic right level II cervical node. The contrast enhanced CT of the neck showed no invasion of the tongue muscles from the primary tumor and subcentimeter right level II cervical node. Contrast enhanced PET/CT provided the clinical information about the primary tumor as well as the nodal metastasis required for management decisions in a single imaging study.
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