Thesis (Ph.D.) - Cairo University - Faculty of Medicine- Department of Nuclear Medicine

Introduction: nasopharyngeal carcinoma (NPC) is an aggressive epithelial malignancy prone to loco-regional and distant metastases. Aim of the work: to explore the impact of ¹⁸F-FDG-PET/CT in NPC either during initial staging or re-staging after end of therapy versus conventional imaging modalities (MRI and CT). Patients and methods: 40 patients with biopsy proven NPC (mean age 14.8, SD±9; range 9-49), mostly of non-keratinizing undifferentiated type III (95%) were included in the study. Whole body ¹⁸F-FDG-PET/CT, MRI and CE-CT of the head and neck were obtained in all patients, as well as MRI and CE-CT of the chest and the abdomen (the interval between the different modalities ranged from 2-28 days). The findings of PET/CT were compared with those of conventional imaging (CI) modalities regarding TNM staging either initially or after end of therapy. Results: the studied group of patients was divided into two categories for analysis; 21 patients were analyzed at initial staging (52.5%) and 19 patients (47.5%) were analyzed for restaging after end of 1st line of therapy. In initial staging; The T stage detectability revealed a higher sensitivity for CI versus PET/CT with sensitivities{u2019} of 95.2%, 100% and 95.2% for PET/CT, MRI and CT respectively. Regarding the N stage; PET/CT shows higher sensitivity than CI modalities with sensitivities{u2019} values of 95.2%, %, and 88.8% and 77.7% for PET/CT, MRI, and CT respectively. In respect of the M stage; the sensitivity values were 80%, 60% and 25% for PET/CT, MRI, and CT respectively. In re-staging; PET/CT has higher sensitivity than CI modalities for local residual/recurrence (T), nodal (N) and distant metastases (M) with values of 100% and 86% in T stage, 85.7% and 57% in N stage and 100% and 66 % in M stage for PET/CT and CI modalities respectively

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