Prediction of distant metastases from nasopharyngeal carcinoma: Improved diagnostic performance of MRI using nodal volume in N1 and N2 stage disease

Distant metastases (DM) are common in nasopharyngeal carcinoma (NPC) arising in up to 30% of patients and DM are now the major cause of NPC mortality [1]. Distant metastases at presentation change treatment from curative to palliative regimes [2,3]. However, only a minority of these DM (4–11%) occur at presentation and so in NPC endemic regions whole body fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) tends to be reserved for at risk patients only. The vast majority of DM are diagnosed after treatment, usually within the first 5years [4].

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