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Table 2 Number of disease recurrences detected by imaging studies in 5 years per 10,000 patients

From: Liquid biopsy posttreatment surveillance in endemic nasopharyngeal carcinoma: a cost-effective strategy to integrate circulating cell-free Epstein-Barr virus DNA

Surveillance strategy

Imaging-detected local relapse

Imaging-detected regional relapse

Imaging-detected distant metastasis

Total imaging studies performed

Imaging studies per recurrencea

Pb

Stage I

 cfEBV DNA-guided MRI + CT + BS

102

20

87

19,703

94

 

 cfEBV DNA-guided PET/CT

103

21

98

19,676

89

 

 Routine MRI + CT + BS

112

23

78

97,493

457

< .001

 Routine PET/CT

119

24

99

97,519

405

< .001

Stage II

 cfEBV DNA-guided MRI + CT + BS

199

306

354

21,265

25

 

 cfEBV DNA-guided PET/CT

202

307

399

21,170

23

 

 Routine MRI + CT + BS

216

316

309

101,670

121

< .001

 Routine PET/CT

228

319

410

101,595

106

< .001

Stage III

 cfEBV DNA-guided MRI + CT + BS

344

339

596

25,010

20

 

 cfEBV DNA-guided PET/CT

349

340

671

24,855

18

 

 Routine MRI + CT + BS

368

349

538

118,328

94

< .001

 Routine PET/CT

389

350

672

118,204

84

< .001

Stage IV

 cfEBV DNA-guided MRI + CT + BS

571

484

1166

25,893

12

 

 cfEBV DNA-guided PET/CT

580

486

1324

25,598

11

 

 Routine MRI + CT + BS

610

502

1101

117,829

53

< .001

 Routine PET/CT

640

508

1372

117,440

47

< .001

  1. Abbreviations: BS, bone scintigraphy; cfEBV, cell-free Epstein-Barr virus; CT, computed tomography; MRI, magnetic resonance imaging; PET/CT, positron emission tomography/computed tomography
  2. a Indicate the number of imaging studies required to detect one recurrence, which was calculated by dividing the number of total imaging studies by the number of imaging-detected disease recurrences (including local relapse, regional relapse and distant metastasis).
  3. b Two-sided P values were calculated using Welch’s t-test for comparisons between cfEBV DNA-guided MRI + CT + BS and routine MRI + CT + BS; cfEBV DNA-guided PET/CT and routine PET/CT