Whole-Body F-18-Fdg Pet in Recurrent or Metastatic Nasopharyngeal Carcinoma

The aim of this retrospective study was to evaluate the sensitivity and prognostic significance of whole-body 18F- FDG PET for nasopharyngeal carcinoma (NPC) patients for whom there was a suspicion of recurrence or metastasis by conventional radiologic or clinical findings during their follow-up examinations. Methods: Whole-body 18F-FDG PET examinations were performed on 64 Taiwanese NPC patients (14 female, 50 male; mean age ± SD , 45.8 ± 13.0 y; age range, 16–75 y) 4–70 mo (mean ± SD, 14.1 ± 13.5 mo) after radiotherapy or induction chemotherapy followed by concurrent chemoradiotherapy from February 1997 to May 2001. The accuracy of 18F-FDG PET detection for each patient was determined by the histopathologic results or other clinical evidence. Results: The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 18F -FDG PET images in the diagnosis of NPC recurrence or metastases and secondary primary cancers were 92%, 90%, 92%, 90%, and 91%, respectively. Furthermore, the presence of 18 F-FDG hypermetabolism was highly correlated with the survival time of NPC patients. Conclusion: Whole-body 18F- FDG PET is a sensitive follow-up diagnostic tool for the evaluation of NPC recurrences and metastases. It is also an effective prognostic indicator for NPC patients. To determine the optimized utilization of 18F- FDG PET in the follow-up for NPC patients, further cost-effectiveness analysis of 18F-FDG PET in combination with conventional management is necessary