AI Article Synopsis
- The study evaluates the necessity of whole-body F-FDG PET/CT scans for M staging in newly diagnosed nasopharyngeal carcinoma (NPC) patients, as not all patients benefit from this procedure.
- Analyzing data from 264 patients, researchers identified that factors such as EBV positivity and certain staging levels (N and T) were significantly associated with an increased risk of distant metastasis.
- The findings suggest that only patients categorized as medium or high risk, specifically those with elevated EBV DNA levels and advanced T or N staging, require the F-FDG PET/CT scan for effective M staging.
Article Abstract
Objective: Although whole-body fluorine-18 fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/computed tomography (CT) (F-FDG PET/CT) is commonly used for M staging of newly diagnosed nasopharyngeal carcinoma (NPC), some patients may not benefit from this procedure. The present study investigated which patients require this modality for M staging.
Methods: Whole-body F FDG PET/CT results and clinical data were collected for 264 patients with newly diagnosed NPC. The relationships between distant metastasis and age, gender, pathological type, lesion size, SUVmax-T, T staging, N staging, SUVmax-N and Epstein-Barr virus (EBV) quantity were retrospectively analysed to identify factors associated with increased risk.
Results: Of the 264 patients, only 37 (14.0%) were diagnosed with distant metastasis. Using multiple logistic regression analysis, EBV-positivity (OR=13.1; 95% CI:1.61,106.80), N staging (OR=3.05; 95% CI:1.41,6.63) and T staging (OR=2.16; 95% CI:1.10, 4.24) were significantly related to distant metastasis (all P<0.05). EBV DNA levels≥9000copies/ml, N3 stage and T4 stage were identified as high risk factors. A low risk of distant metastasis was found in patients with 0-1 risk factors and in those with 2 specific risk factors, T3/T4 and N2/N3 staging. Patients with EBV DNA levels ≥9000copies/ml and N3 or T4 staging and those with 3 risk factors had a medium or high risk, with a much higher incidence of distant metastasis (χ=29.896, P=0.000), and needed a whole-body F FDG PET/CT for M staging.
Conclusions: Due to the low incidence of distant metastasis, only patients with medium or high risk need to undergo a whole-body scan.
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| http://dx.doi.org/10.1016/j.ejrad.2017.02.002 | DOI Listing |
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