18F-FDG Role of PET-MRI in nodal staging of head and neck squamous cell carcinoma (HNSCC): imaging findings and review of literature.

Congress:

ECR 2020

Poster Number:

C-06918

Type:

Educational Exhibit

Keywords:

Not applicable, Metastases, Cancer, Staging, Molecular imaging, PET-MR, MR, Oncology, Hybrid Imaging, Head and neck, Hybrid, Molecular and Translational Imaging

Authors:

A. Pirazzini¹, A. Rago², F. Crimì³, D. cazzador², D. Borsetto², C. lacognata², C. Aliberti⁴, D. Cecchin⁵, E. Quaia²; ¹Argenta/IT, ²Padova/IT, ³Vicenza/IT, ⁴Padua/IT, ⁵Ponte San Nicolò (PD)/IT

DOI:

10.26044/ecr2020/C-06918

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06918

Fig. 1: T2w (a), contrast-enhanced VIBE (b) and fused PET-MR (c) axial images showing a...

Fig. 2: T2w (a), contrast-enhanced VIBE (b) and fused PET-MR (c) axial images showing a...

Fig. 3: T2w (a), contrast-enhanced VIBE (b) and fused PET-MR (c) axial images showing a...

Learning objectives

Describe and illustrate imaging features of nodal metastases in HNSCC with PET-MRI Review of the literature concerning the role of PET-MRI in HNSCC nodal staging

Background

HNSCC is the sixth most common malignancy worldwide and its main risk factors are the consumption of tobacco and alcohol, and human papillomavirus (HPV) infection, the latter accounting for ~30% of oropharyngeal cancers [1]. The 8th Edition of the American Joint Committee on Cancer (AJCC) Staging Manual separates oropharyngeal cancers into HPV+ and HPV- using immunohistochemical testing for p16 and introduces a different N staging system between the two subtypes: HPV+ are staged based on laterality and dimension of the lymph nodes; assessing extranodal extension...

Findings and procedure details

PET-MRI dimensional, morphological and functional characteristics of metastatic neck lymph nodes The diagnosis of metastatic cervical lymph nodes is challenging and made even more difficult by the multiple criteria available. A normal sized lymph node can still be reported as metastatic if one or more of the other criteria are met. Suggested dimensional, morphological and functional criteria for the diagnosis of metastatic cervical lymph nodes are (Tab.1): Size Short-axis diameter cutoff on MRI is 10 mm [3] except for lateral retropharyngeal nodes (VIIa) that have...

Conclusion

Deep knowledge of head and neck anatomy and imaging features of HNSCC is needed to correctly assess the N staging. 18F-FDG PET-MR is a feasible diagnostic imaging technique for N staging of HNSCC, with high sensitivity and specificity.

Personal information and conflict of interest

A. Pirazzini; Argenta/IT - nothing to disclose A. Rago; Padua/IT - nothing to disclose F. Crimì; Vicenza/IT - nothing to disclose D. Cazzador; Padua/IT - nothing to disclose D. Borsetto; Padua/IT - nothing to disclose C. Lacognata; Padua/IT - nothing to disclose C. Aliberti; Padua/IT - nothing to disclose D. Cecchin; Ponte San Nicolò (PD)/IT - nothing to disclose E. Quaia; Padua/IT - nothing to disclose

References

McDermott, J.D. and D.W. Bowles, Epidemiology of Head and Neck Squamous Cell Carcinomas: Impact on Staging and Prevention Strategies. Curr Treat Options Oncol, 2019. 20(5): p. 43. Almulla, A., et al., Radiologic-Pathologic Correlation of Extranodal Extension in Patients With Squamous Cell Carcinoma of the Oral Cavity: Implications for Future Editions of the TNM Classification. Int J Radiat Oncol Biol Phys, 2018. 102(4): p. 698-708. Hoang, J.K., et al., Evaluation of cervical lymph nodes in head and neck cancer with CT and MRI: tips, traps, and...