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

doi:10.1002/lary.28602

. 2021 Jan;131(1):E163-E169.

doi: 10.1002/lary.28602. Epub 2020 Mar 6.

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

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
² Institute of Nuclear Medicine, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
³ Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
⁴ Institute of Pathology, University of Bern, Bern, Switzerland.
⁵ Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
⁶ Department of Biomedical Research, University of Bern, Bern, Switzerland.

PMID: 32142169
DOI: 10.1002/lary.28602

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

Sean C Sheppard et al. Laryngoscope. 2021 Jan.

. 2021 Jan;131(1):E163-E169.

doi: 10.1002/lary.28602. Epub 2020 Mar 6.

Authors

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
² Institute of Nuclear Medicine, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
³ Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
⁴ Institute of Pathology, University of Bern, Bern, Switzerland.
⁵ Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
⁶ Department of Biomedical Research, University of Bern, Bern, Switzerland.

PMID: 32142169
DOI: 10.1002/lary.28602

Abstract

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, 131:E163-E169, 2021.

Keywords: Head and neck squamous cell carcinoma; extracapsular extension; magnetic resonance imaging.; positron emission tomography/computed tomography.

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References

BIBLIOGRAPHY

1. Mamelle G, Pampurik J, Luboinski B, Lancar R, Lusinchi A, Bosq J. Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg 1994;168:494-498.
1. Marur S, Forastiere AA. Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment. Mayo Clin Proc 2016;91:386-396.
1. Cerezo L, Millan I, Torre A, Aragon G, Otero J. Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer: a multivariate study of 492 cases. Cancer 1992;69:1224-1234.
1. Vila PM, Stucken CL, Morris LGT, et al. Reduced impact of nodal metastases as a prognostic factor for tonsil cancer in the HPV era. Eur Arch Otorhinolaryngol 2013;271:2523-2529.
1. Keane FK, Chen Y-H, Neville BA, et al. Changing prognostic significance of tumor stage and nodal stage in patients with squamous cell carcinoma of the oropharynx in the human papillomavirus era. Cancer 2015;121:2594-2602.

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[1] Mamelle G, Pampurik J, Luboinski B, Lancar R, Lusinchi A, Bosq J. Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg 1994;168:494-498.

[2] Mamelle G, Pampurik J, Luboinski B, Lancar R, Lusinchi A, Bosq J. Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg 1994;168:494-498.

[3] Marur S, Forastiere AA. Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment. Mayo Clin Proc 2016;91:386-396.

[4] Marur S, Forastiere AA. Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment. Mayo Clin Proc 2016;91:386-396.

[5] Cerezo L, Millan I, Torre A, Aragon G, Otero J. Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer: a multivariate study of 492 cases. Cancer 1992;69:1224-1234.

[6] Cerezo L, Millan I, Torre A, Aragon G, Otero J. Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer: a multivariate study of 492 cases. Cancer 1992;69:1224-1234.

[7] Vila PM, Stucken CL, Morris LGT, et al. Reduced impact of nodal metastases as a prognostic factor for tonsil cancer in the HPV era. Eur Arch Otorhinolaryngol 2013;271:2523-2529.

[8] Vila PM, Stucken CL, Morris LGT, et al. Reduced impact of nodal metastases as a prognostic factor for tonsil cancer in the HPV era. Eur Arch Otorhinolaryngol 2013;271:2523-2529.

[9] Keane FK, Chen Y-H, Neville BA, et al. Changing prognostic significance of tumor stage and nodal stage in patients with squamous cell carcinoma of the oropharynx in the human papillomavirus era. Cancer 2015;121:2594-2602.

[10] Keane FK, Chen Y-H, Neville BA, et al. Changing prognostic significance of tumor stage and nodal stage in patients with squamous cell carcinoma of the oropharynx in the human papillomavirus era. Cancer 2015;121:2594-2602.

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

Affiliations

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

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