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Detection of Occult Primary Tumors in Patients with Cervical Metastases of Unknown Primary Tumors: Comparison of Three-Dimensional THRIVE MR Techniques with Two-Dimensional Spin-Echo MR or Contrast-Enhanced CT Imaging

Other Titles
 원발병소 불명 경부 림프절 전이암 환자에서 원발병소 확인: 3차원 THRIVE 자기공명영상, 2차원 스핀에코 자기공명영상, 컴퓨터 단층촬영의 임상적 유용성 비교 
 College of Medicine (의과대학) 
 Dept. of Radiology (영상의학교실) 
Issue Date
Objective: We evaluated and compared the utility of postcontrast three-dimensional (3D) T1-weighted high resolution isotropic volume examination (THRIVE), spin-echo (SE) T1-weighted MR, and contrast-enhanced CT imaging for detecting occult primary tumors in patients with cervical lymph node metastases. Materials and Methods: Seventy-three consecutive patients with tumors that went undetected during endoscopic or physical examinations underwent preoperative contrast-enhanced CT and MR imaging (SE and 3D THRIVE) after gadolinium injection. Guided biopsy or surgery results served as reference standards. The diagnostic performances of the imaging techniques were compared with McNemar’s tests. Results: Primary tumors were identified in 59 (80.8%) of the 73 patients after surgery. Of these, 36 were found in the palatine tonsil, 11 in the base of the tongue, seven in the nasopharynx, and five in the pyriform sinus. The sensitivity (72.9%) and accuracy (71.2%) of 3D THRIVE for detecting primary tumors were higher than were those of SE T1-weighted MR (49.2% and 53.4%, P ≤ 0.002) or CT (36.4% and 46.4%, P ≤ 0.001). The specificities of these techniques did not differ. The diagnostic performance of 3D THRIVE (area under the curve [AUC] = 0.681) for detecting tumors did not differ from that of SE T1-weighted MR or CT (AUC = 0.671 and 0.608, P > 0.05). Conclusion: 3D THRIVE was more sensitive at detecting primary tumors than was SE T1-weighted MR or CT imaging in patients with cervical metastases of unknown primary tumors; this sequence may improve biopsy and therapeutic planning in these patients.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 2. Thesis
Yonsei Authors
Yoo, Moon Gyu(유문규)
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