The role of 18F-FDG PET/CT in detecting recurrence and metastasis in posttreatment nasopharyngeal carcinoma patients with elevated Epstein-Barr virus DNA.

Objective: The objective of this study is to evaluate and compare the clinical utility of 18F-fluoro-2-deoxy-d-glucose PET and computed tomography (18F-FDG PET/CT) in detecting recurrence and metastasis in patients with nasopharyngeal carcinoma (NPC) who exhibit elevated levels of Epstein-Barr virus (EBV) DNA following treatment.

Methods: A total of 103 patients with NPC were studied retrospectively. All patients were in remission following initial treatment. Elevated EBV DNA was found for the first time at review and 18F-FDG PET/CT imaging was completed. The number of tracer lesions and the maximum standardized uptake value in the body region were recorded to evaluate the diagnostic ability of 18F-FDG PET/CT. The final diagnosis was confirmed either through pathology or clinical follow-up lasting 6 months or longer.

Results: Out of the 103 patients, 97 patients had a total of 434 lesions that were ultimately diagnosed as recurrent or metastatic. In patient-based analyses, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 18F-FDG PET/CT imaging were 100%, 50%, 97%, and 100%, respectively. In lesion-based analyses, the sensitivity, specificity, PPV, and NPV of 18F-FDG PET/CT imaging were 99.3%, 30.3%, 94.9%, and 83.3%, respectively.

Conclusion: 18F-FDG PET/CT demonstrates potential value in detecting recurrence and metastasis of NPC.