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[Objective]To evaluate the prognostic value of skull-base invasion of nasopharyngeal carcinoma(NPC)based on magnetic resonance imaging(MRI).[Methods]A total of 924 patients who were diagnosed with NPC between 2003 and 2004,had undergone MRI scan and received mdiothempy as their primary treatment,and had no distant metastasis were included in this study.MRI images and medical records were analyzed retrospectively.All the 924 eases.patients who developed skull-base invasions based on MRI,315 patients with T3 disease and 227 patients with T2 disease were selected for analysis.The staging was according to the sixth edition of the American Joint Commission on Cancer(AJCC)staging system.[Results]Incidence of skullbase invasion according to MRI was 55.4%.Of 924 cases.skull-base invasion on MRI was not an independent prognostic factor for overall survival(OS)and distant metastasis-free survival(DMFS),but was a marginally significant independent prognostic factor for local relapse-free survival(LRFS),P=0.068.Grading of MRI-detected skull-base erosion according to the site of invasion was an independent prognostic factor for OS(P=0.002 and P=0.005)and DMFS(P=0.001 for both)in the 512 patients with skull-base invasions and 315 patients with T3 disease.Severe-grade of skull-base invasion on MRI was an independent prognostic factor for OS and DMFS in the 924 patients(P ＜ 0.001 for both).No significant differences were observed on OS,LRFS,and DMFS between T2a patients and T3 patients with low-grade of MRI-deteeted skull-base involvement.[Conclusions]Skull-base invasion based on MRI is not an independent prognostic factor for NPC.However,severe-grade of invasion according to the site of involvement has positive prognostic value.
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Objective: To compare the diagnostic values of magnetic resonance imaging (MRI), enhanced computed tomography (CT), and positron emission tomography (PET)-CT using 18F-fluoro-2-deoxyglucose (FDG) in detecting skull base invasion of nasopharyngeal carcinoma (NPC) and provide the evidence for differentiated diagnosis of the skull base invasion of NPC. Methods: The fifty seven patients were scanned by MRI, enhanced CT, and PET-CT. The three imaging examinations were finished within 20 days. The diagnosis standards were based on histopathologic findings or clinical and imaging follow-up results within 6 months. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the three scanning technologies were compared. Results: For detecting skull base invasion of NPC, the sensitivity of enhanced CT, MRI, and PET-CT were 68.18%, 84.09%, and 97.67%, respectively; the specificity were 76.92%, 69.23%, and 57.14%, respectively; the accuracy were 70.18%, 80.70%, and 87.72%, respectively; PPV were 90.90%, 90.24%, and 87.50%, respectively; NPV were 41.67%, 56.25%, and 88.89%, respectively. PET-CT was better than enhanced CT in sensitivity, accuracy, and NPV (P <0.05). It was also better than MRI in sensitivity and NPV (P <0.05). Conclusion: Among three imaging technologies,PET-CT has obvious advantage in detecting skull base invasion of NPC patients, especially for new patients.
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Purpose:To investigate the detection ability of CT and MRI in skull base invasion in nasopharyngeal carcinoma. Methods:Sixty patients with nasopharyngeal carcinoma were examined by plain CT scan at axial sections and MRI of T_(1)WI at axial , coronal and sagittal sections and T_(2)WI at axial sections fast spin echo (FSE). Results:The overall positive rates of skull base invasion detected by CT and MRI were 16.7% and 53.3%(?~2 Test,P
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Objective To investigate the detecting ability of single photon emission computed tomography (SPECT) and CT in skull base invasion in nasopharyngeal carcinoma. Methods Sixty three patients with nasopharyngeal carcinoma were examined by whole body and skull base SPECT and CT of nasopharynx and skull base before radiotherapy. The results were double blind compared and evaluated. Results The overall positive rates of skull base invasion detected by SPECT and CT were 63.5% and 25.4%. In patients with headache, cranial nerve palsy and both, they were 87.9%,93.3%,92.3% and 42.4%,46.7%,46.2%. In patients with T 1+T 2 and T 3+T 4 lesions, they were 37.5%,90.3% and 0.0%,51.6%. In patients with N 0+N 1 and N 2+N 3 lesions, they were 63.9% ,63.0% and 19.4%,33.3%. The positive rates of SPECT were higher than those of CT (McNemar Test, P