Alessandro Stecco MD, Presenter: Nothing to Disclose

Silvio Ciolfi, Abstract Co-Author: Nothing to Disclose

Roberta Matheoud, Abstract Co-Author: Nothing to Disclose

Gianmauro Sacchetti, Abstract Co-Author: Nothing to Disclose

Marco Brambilla, Abstract Co-Author: Nothing to Disclose

Alessandro Carriero MD, Abstract Co-Author: Nothing to Disclose

To assess if multimodal assesment by PET/CT and MRI/DWI rigid image coregistration can increase diagnostic accuracy in staging HNSCC.

In the period 2011-2012 we enrolled 25 patients affected by head and neck HNSCC tumour, at first diagnosis. Each patient after clinical and fibroscopic evaluation underwent to 18FDG-PET-CT and MRI with DWI in an interval of maximum 12 days.  MRI and PET/CT were separately (blinded each other)  read by an experienced Radiologist and Nuclear Medicine Specialist, on a read form with T and N parameters. A consensus reading was then performen on a dedicated workstation loaded with a co-registration and image fusion software.  The Gold Standard was the histological assesment and clinico-radiological follow-up. Interobserver agreement between the two readers has been carried out by Cohen's K test. Diagnostic accuracy together with specificity, sensitivity, PPV and NPV values have been calculated. We also calculated ROC curves and AUC for SUV and ADC in Lymphnodes.  All statistic has been carried out by mean of MedCalc software.

Interobserver agreement has been found "discrete".   About Nodal involvement:  Coregistered PET/CT and MR reading session, showed diagnostic accuracy of 91% (vs 76% of PET/CT and 79%/88% of MRI-DWI/MRI-STIR) , PPV 96%(vs 95% of PET /CT and 88%/86% of MRI-DWI/MRI-STIR)  (i.c. 78,88%-99,89%) and NPV 80% (vs 53%, 63% and 100% of PET/CT, MRI-DWI and MR-STIR) (i.c. 42,19%-97,89%), sensitivity and specificity respectively of 92% (vs 72%, 94% and 100%)  (i.c. 73,97%-99,02%), specificity of 89% (vs 89%, 67% and 56%) (i.c. 51,75%-99,72%).  AUC for coregistered MR-PET /CT images was  of 0,91, statistically different respect to others thechnique (p<0,05). ROC analysis on ADC value to differentiate benignant to malignant Nodes, showed a cut off value of 1,03x10-3 mm2/s About T evaluation: Coregistered PET/CT and MRI , showed a diagnostic accuracy of 92% (vs 60% of PET/CT and 88% of MRI), sensitivity of 94% (vs 53% AND 94%)(i.c.71,31%-99,85%), specificity 88% (vs 75% and75%) (i.c. 47,35-99,68%), PPV and NPV of 94% (vs 82% and 89%) (71,31%-99,85%) and 88% (vs 43% and 86%) (i.c. 47,35%-99,68%).

Multimodal Image coregistration increases Diagnostic Accuracy  for HNSCC cancer, both on T and N evaluation. 

The secondary image coregistration is a "low cost" diagnostic tool that increases  the staging accuracy in head and neck cancer.  

Stecco, A, Ciolfi, S, Matheoud, R, Sacchetti, G, Brambilla, M, Carriero, A, Combined  PET/CT and MRI/DWI by Rigid Image Coregistration Increases Diagnostic Accuracy in Head and Neck Tumours .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045517.html