Prognostic Value of 18F-Fluorodeoxyglucose-Positron Emission Tomography/Magnetic Resonance Imaging in Patients With Hypopharyngeal Squamous Cell Carcinoma.

OBJECTIVE: The aim of the study is to investigate the value of pretreatment integrated positron emission tomography/magnetic resonance imaging (PET/MRI) in predicting the prognosis of patients with hypopharyngeal squamous cell carcinoma (HSCC). METHODS: Twenty-one untreated patients with HSCC who underwent PET/MRI before treatment were enrolled. We analyzed the value of PET/MRI parameters in predicting the progression-free survival (PFS) and overall survival (OS) of HSCC patients. Kaplan-Meier method and log rank test were used to perform univariate survival analysis, whereas Cox proportional hazard regression models were used to perform multivariate analysis. RESULTS: Of the 21 patients with a median follow-up time of 20.3 months (range, 4.2-37.6 months), 2 (9.5%) had local recurrence, 2 (9.5%) had distant metastases, and 8 (38.1%) died because of cancer. Univariate analysis showed that T stage, clinical stage, total lesion glycolysis (TLG), and metabolic tumor volume (MTV) were significant prognostic factors for PFS (P < 0.05). T stage, clinical stage, TLG, MTV, the mean apparent diffusion coefficient (ADCmean), and the minimal apparent diffusion coefficient (ADCmin) were significant prognostic factors for OS (P < 0.05). The Cox proportional hazard regression model revealed that MTV was an independent prognostic factor for PFS, and TLG was an independent prognostic factor for OS (P < 0.05). CONCLUSIONS: Metabolic tumor volume was an independent predictor of PFS in patients with HSCC, while TLG was an independent predictor of OS. T stage, clinical stage, ADCmean, and ADCmin are potential prognostic indicators for HSCC. Positron emission tomography/magnetic resonance imaging can provide effective information for predicting the prognosis for HSCC patients.

Diagnosis of Postlaminar Optic Nerve Invasion in Retinoblastoma With MRI Features.

BACKGROUND: Retinoblastomas (RBs) with postlaminar optic nerve invasion (PLONI) increases the risk of local recurrence or systemic metastasis. Most MRI studies on PLONI focused on optic nerve enhancement and tumor size, with reported relatively high specificity (84-98%) but low sensitivity (37-78%), which shows room for improvement, especially with regard to sensitivity. PURPOSE: To evaluate the diagnostic performance for detecting PLONI with RB using MRI features. STUDY TYPE: Retrospective. POPULATION: Fifty patients with histopathologic PLONI and 70 patients without PLONI of RB. FIELD STRENGTH/SEQUENCE: 1.5T and 3.0T, precontrast axial T1 -weighted and T2 -weighted, postcontrast axial, coronal and oblique-sagittal T1 -weighted. ASSESSMENT: The eyes were histopathologically analyzed and the preoperative MRI features of the eyes were independently evaluated by three observers. STATISTICAL TESTS: MRI features suggesting the presence of PLONI were identified by univariate and multivariable analysis. Receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to analyze diagnostic performance. RESULTS: Significant independent diagnostic factors for PLONI include: 1: Bilateral tumor (odds ratio [OR], 15.32; 95% confidence interval [CI]: 1.63-143.51); 2: Tumor with total coverage of the optic disk (OR, 6.43; 95% CI: 1.04-39.79); and 3: Optic nerve enhancement (OR, 8.43; 95% CI: 3.50-20.31). On the other hand, isointense signal of tumor on T2 WI (OR, 0.30; 95% CI: 0.12-0.75) was an independent diagnostic factor in excluding PLONI. ROC analysis showed AUC of 0.84 (95% CI: 0.77-0.91, P < 0.0001) for PLONI. Based on the cutoff of maximum Youden index, the sensitivity, specificity, and accuracy were 82%, 73%, and 77%, respectively. DATA CONCLUSION: MRI features of RB showed a strong association with PLONI. The model of MRI features demonstrated promising diagnostic performance in detecting PLONI. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1045-1052.

Comparative Study Between Integrated Positron Emission Tomography/Magnetic Resonance and Positron Emission Tomography/Computed Tomography in the T and N Staging of Hypopharyngeal Cancer: An Initial Result.

OBJECTIVE: To compare the diagnostic accuracy of positron emission tomography/magnetic resonance (PET/MR) versus PET/computed tomography (PET/CT) for T and N staging of hypopharyngeal cancer. METHODS: Integrated PET/MR and PET/CT examinations were performed in 20 patients with hypopharyngeal cancer after same-day single injection. Eleven of 20 patients underwent surgery with histologic findings directly compared with imaging findings. Statistical analysis included Spearman correlation and McNemar test. RESULTS: Accuracy of PET/MR, PET/CT, and MRI for T staging was 81.8%, 63.6%, and 72.7%, respectively. Sensitivity and specificity for detecting metastatic lymph nodes was 88.2% and 98.2% on PET/MR, 76.5% and 98.3% on PET/CT, and 64.7% and 94.7% on MRI. CONCLUSIONS: The PET/MR and PET/CT provide comparable results for assessing hypopharyngeal carcinoma and detecting metastatic lymph nodes.

ACR Appropriateness Criteria on low back pain.

Acute low back pain with or without radiculopathy is one of the most common health problems in the United States, with high annual costs of evaluation and treatment, not including lost productivity. Multiple reports show that uncomplicated acute low back pain or radiculopathy is a benign, self-limited condition that does not warrant any imaging studies. Guidelines for recognition of patients with more complicated status can be used to identify those who require further evaluation for suspicion of more serious problems and contribute to appropriate imaging utilization.