• Anne Chaput, Philippe Robin, Fabien Podeur, Morgan Ollivier, Nathalie Keromnes, Valentin Tissot, Michel Nonent, Pierre-Yves Salaün, Jean Rousset, and Ronan Abgral.
• Department of Nuclear Medicine, University Hospital of Brest, Brest, France.
• Laryngoscope. 2018 Feb 1; 128 (2): 378-385.

Objectives/HypothesisThe aim of this study was to assess and compare the diagnostic accuracy of 18 fluorodesoxyglucose positron emission/computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI) to detect T1-T2 head and neck squamous cell carcinoma (HNSCC).Study DesignProspective case series.MethodsThirty-five consecutive patients with histologically proven T1-T2 HNSCC were prospectively included. All patients underwent pretherapeutic FDG-PET/CT and MRI. Two nuclear medicine physicians and 2 radiologists blindly reviewed all FDG-PET/CT and MRI, respectively. A five-point qualitative scale was used to estimate tumor detection ability. Sensitivity of each modality was compared together using a McNemar test. Interobserver variability was assessed by kappa index (κ) of Cohen statistics. Maximal standardized uptake value (SUVMAX ), metabolic tumor volume (MTV) in FDG-PET/CT, and gadolinium enhancement (%GE) in MRI of each tumor were recorded and compared with T stage using a Mann-Whitney test. Tumor-to-normal tissue ratios in FDG-PET/CT and MRI (TNRPET and TNRMRI ) were calculated and compared together using a Student t test.ResultsAmong the 35 primary tumors, 29 were detected by FDG-PET/CT and 22 by MRI. MRI detected none of the six lesions incorrectly identified by FDG-PET/CT. FDG-PET/CT correctly identified seven of the 13 MRI false-negative results. Sensitivity of FDG-PET/CT to detect T1-T2 HNSCC was significantly higher than MRI (83% vs. 63%, P = .015). T stage was significantly correlated with MTV (P = .002) unlike with SUVMAX (P = .06) and %GE (P = .70). TNRPET was significantly higher than TNRMRI (3.5 ± 3.2 vs. 1.2 ± 0.3, P < .0001).ConclusionsOur study showed a higher diagnostic accuracy of FDG-PET/CT than MRI to detect T1-T2 HNSCC with a good interobserver agreement.Level Of Evidence4. Laryngoscope, 128:378-385, 2018.© 2017 The American Laryngological, Rhinological and Otological Society, Inc.

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