Use of MRI and FDG‐PET/CT to predict fixation of advanced hypopharyngeal squamous cell carcinoma to prevertebral space

Abstract

Background

We evaluated the ability of different (18F)fluoro‐deoxy‐d‐glucose (FDG)‐positron emission tomography (PET)‐based and magnetic resonance (MR)‐based parameters to identify prevertebral space (PVS) infiltration by hypopharyngeal carcinoma.

Methods

Retrospective study on 59 patients with advanced hypopharyngeal squamous cell carcinoma undergoing cross‐sectional imaging and triple endoscopy for staging.

Results

Obliteration of retropharyngeal fat plane on T1‐weighted MR images was found more often (P < .001) in tumors fixated to the PVS. Complete fat plane obliteration best predicted tumor fixation to PVS (accuracy 99%; CI: 97%‐100%; P < .001). With similar accuracy, PET‐based models predicted PVS fixation (combination of standardized uptake value [SUV_max] of the primary tumor and presence of focal FDG‐uptake in prevertebral muscles [accuracy 98%; CI 94%‐100%; P < .001]; metabolic tumor volume [MTV] [accuracy 98%; CI 95%‐100%; P < .001]).

Conclusion

Both the MR‐based parameter of complete fat plane obliteration and PET‐based models (increased SUV_max in combination with presence of focal FDG‐uptake of prevertebral muscles; increased MTV) predict PVS involvement independently with high accuracy.

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