Comparison of 4 modalities for distant metastasis staging in endemic nasopharyngeal carcinoma

Abstract

Background. Endemic nasopharyngeal carcinoma (NPC) commonly metastasizes to the lungs, liver, and bones. This study aims to assess the efficacy of 4 distant metastasis staging modalities, namely (1) conventional work‐up comprising chest X‐ray, liver ultrasound, and skeletal scintigraphy, (2) CT of the thorax, abdomen, and skeletal scintigraphy, (3) (18)F‐fluorodeoxyglucose positron emission tomography (FDG‐PET), and (4) integrated FDG‐PET/CT. Methods. Seventy‐eight consecutive patients diagnosed with NPC were enrolled and followed up for a minimum of 6 months to confirm the staging at diagnosis. Results. Six patients (7.7%) had distant metastases at diagnosis. The sensitivities and specificities of conventional work‐up, combined CT and skeletal scintigraphy, FDG‐PET, and FDG‐PET/CT were 33.3%, 66.7%, 83.3%, and 83.3%; and 90.3%, 91.7%, 94.4%, and 97.2%, respectively. The corresponding accuracies were 85.9%, 89.7%, 93.6%, and 96.2%. Conclusions. FDG‐PET/CT is the most sensitive, specific, and accurate modality for distant metastasis staging of endemic NPC. © 2008 Wiley Periodicals, Inc. Head Neck, 2009