PT  - JOURNAL ARTICLE
AU  - Patel, L.D.
AU  - Bridgham, K.
AU  - Ciriello, J.
AU  - Almardawi, R.
AU  - Leon, J.
AU  - Hostetter, J.
AU  - Yazbek, S.
AU  - Raghavan, P.
TI  - PET/MR Imaging in Evaluating Treatment Failure of Head and Neck Malignancies: A Neck Imaging Reporting and Data System–Based Study
AID  - 10.3174/ajnr.A7427
DP  - 2022 Feb 17
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2022/02/17/ajnr.A7427.short
4100  - http://www.ajnr.org/content/early/2022/02/17/ajnr.A7427.full
AB  - BACKGROUND AND PURPOSE: PET/MR imaging is a relatively new hybrid technology that holds great promise for the evaluation of head and neck cancer. The aim of this study was to assess the performance of simultaneous PET/MR imaging versus MR imaging in the evaluation of posttreatment head and neck malignancies, as determined by its ability to predict locoregional recurrence or progression after imaging.MATERIALS AND METHODS: The electronic medical records of patients who had posttreatment PET/MR imaging studies were reviewed, and after applying the exclusion criteria, we retrospectively included 46 studies. PET/MR imaging studies were independently reviewed by 2 neuroradiologists, who recorded scores based on the Neck Imaging Reporting and Data System (using CT/PET-CT criteria) for the diagnostic MR imaging sequences alone and the combined PET/MR imaging. Treatment failure was determined with either biopsy pathology or initiation of new treatment. Statistical analyses including univariate association, interobserver agreement, and receiver operating characteristic analysis were performed.RESULTS: There was substantial interreader agreement among PET/MR imaging scores (κ = 0.634; 95% CI, 0.605–0.663). PET/MR imaging scores showed a strong association with treatment failure by univariate association analysis, with P < .001 for the primary site, neck lymph nodes, and combined sites. Receiver operating characteristic curves of PET/MR imaging scores versus treatment failure indicated statistically significant diagnostic accuracy (area under curve range, 0.864–0.987; P < .001).CONCLUSIONS: Simultaneous PET/MR imaging has excellent discriminatory performance for treatment outcomes of head and neck malignancy when the Neck Imaging Reporting and Data System is applied. PET/MR imaging could play an important role in surveillance imaging for head and neck cancer.AUCarea under curveNI-RADSNeck Imaging Reporting and Data SystemRECISTResponse Evaluation Criteria in Solid TumorsROCreceiver operating characteristicSCCsquamous cell carcinoma