PLoS ONE (Jan 2017)

Whole-body staging of female patients with recurrent pelvic malignancies: Ultra-fast 18F-FDG PET/MRI compared to 18F-FDG PET/CT and CT.

  • Julian Kirchner,
  • Lino Morris Sawicki,
  • Saravanabavaan Suntharalingam,
  • Johannes Grueneisen,
  • Verena Ruhlmann,
  • Bahriye Aktas,
  • Cornelius Deuschl,
  • Ken Herrmann,
  • Gerald Antoch,
  • Michael Forsting,
  • Lale Umutlu

DOI
https://doi.org/10.1371/journal.pone.0172553
Journal volume & issue
Vol. 12, no. 2
p. e0172553

Abstract

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OBJECTIVES:To evaluate the diagnostic feasibility of an ultra-fast 18F-FDG PET/MRI protocol, including T2-w and contrast-enhanced T1-w imaging as well as metabolic assessment (PET) in comparison to 18F-FDG PET/CT and CT for whole-body staging of female patients with suspected recurrence of pelvic malignancies. METHODS:43 female patients with suspected tumor recurrence were included in this study. Suspicion was based on clinical follow-up and abnormal findings on imaging follow-up. All patients underwent a PET/CT and a subsequent PET/MRI examination. Two readers were asked to evaluate ultra-fast PET/MRI, PET/CT as well as CT datasets of PET/CT separately for suspect lesions regarding lesion count, lesion localization and lesion characterization. Statistical analyses were performed both, on a per-patient and a per-lesion basis. RESULTS:Tumor relapse was present in 38 of the 43 patients. Based on CT readings 25/38 tumor relapses were correctly identified. PET/CT enabled correct identification of 37/38 patients, PET/MRI correctly identified 36 of the 38 patients with recurrent cancer. On a lesion-based analysis PET/MRI enabled the correct detection of more lesions, comprising a lesion-based sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 50%, 58%, 76%, 31%, and 53% for CT, 97%, 83%, 93%, 94%, and 92% for PET/CT and 98%, 83%, 94%, 94%, and 94% for PET/MRI, respectively. Mean scan duration of ultra-fast PET/MRI, PET/CT and whole-body CT amounted to 18.5 ± 1 minutes, 18.2 ± 1 minutes and 3.5 minutes, respectively. CONCLUSION:Ultra-fast PET/MRI provides equivalent diagnostic performance and examination time when compared to PET/CT and superior diagnostic performance to CT in restaging female patients suspected to have recurrent pelvic cancer.