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Review ArticleContinuing Education

18F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients

Claudio Spick, Ken Herrmann and Johannes Czernin
Journal of Nuclear Medicine March 2016, 57 (3) 420-430; DOI: https://doi.org/10.2967/jnumed.115.158808
Claudio Spick
1Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, California; and
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Ken Herrmann
1Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, California; and
2Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
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Johannes Czernin
1Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, California; and
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  • FIGURE 1.
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    FIGURE 1.

    Sequential PET/MRI systems: Ingenuity TF (Philips) (A) and PET/CT+MR trimodality setup (GE Healthcare) (B). Both are connected by scanner bed shuttle system and allow sequential PET and MRI data acquisition at 3-T field strengths. (Courtesy of Philips and GE Healthcare.)

  • FIGURE 2.
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    FIGURE 2.

    Integrated PET/MRI systems: Biograph mMR (Siemens) (A) and Signa PET/MR (GE Healthcare) (B). Both allow for simultaneous PET and MRI data acquisitions at 3-T field strengths. (Courtesy of Siemens and GE Healthcare.)

Tables

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    TABLE 1

    Head and Neck Cancer

    StudyDesignPatients (n)PET/MRIIndicationT-stagingN-stagingM-stagingSuperiority
    Kuhn (28)Prospective150SequentialStaging, restaging—NS—ND
    Queiroz (29)Prospective87SequentialRestagingNSNS—ND
    Kubiessa (25)Prospective17SimultaneousStaging, restaging———ND
    Partovi (26)Prospective14SequentialStaging, restaging———ND
    Varoquaux (27)Prospective32SequentialStaging, restaging———ND
    Covello (30)Retrospective44SequentialStaging, restagingNS——ND
    Schaarschmidt (31)Retrospective25SimultaneousStaging, restagingNSNS—ND
    Total369
    • NS = nonsignificant; ND = no difference; — = not reported.

    • View popup
    TABLE 2

    Lung Cancer and Lung Nodules

    StudyDesignPatients (n)PET/MRIIndicationT-stagingN-stagingM-stagingSuperiority
    Schwenzer (36)Not stated10SimultaneousStaging———ND
    Fraioli (37)Prospective50SimultaneousStaging———ND
    Heusch (38)Prospective22SimultaneousStagingNSNS—ND
    Stolzmann (39)Prospective40SequentialLung nodules———CT superior for 18F-FDG–negative lesions
    Rauscher (40)Prospective40SimultaneousLung nodules———CT for lesions < 1 cm
    Chandarana (41)Prospective32SimultaneousLung nodules———ND
    Total194
    • NS = nonsignificant; ND = no difference; — = not reported.

    • View popup
    TABLE 3

    Gastrointestinal Cancer and Neuroendocrine Tumors

    StudyDesignPatients (n)PET/MRICancer typeIndicationT-stagingN-stagingM-stagingSuperiority
    Lee (44)Prospective15SequentialEsophagealStaging—NS—ND
    Paspulati (47)Prospective12SequentialColorectalStaging, restaging———ND (no enhanced CT)
    Brendle (48)Retrospective15SimultaneousColorectalStaging, restaging—NSNSND
    Reiner (49)Prospective55SequentialLiver lesionsStaging, restaging———ND
    Beiderwellen (50)Prospective70SimultaneousLiver lesionsStaging, restaging———ND
    Gaertner (76)Prospective24SimultaneousNETStaging, restaging———ND
    Hope (77)Prospective10SimultaneousNETStaging, restaging———MRI superior for liver lesions; no validation
    Total201
    • NS = nonsignificant; ND = no difference; — = not reported.

    • View popup
    TABLE 4

    Gynecologic and Breast Cancer

    StudyDesignPatients (n)PET/MRICancer typeIndicationT-stagingN-stagingM-stagingSuperiority
    Beiderwellen (53)Prospective19SimultaneousGynecologicRestaging—NSNSND
    Queiroz (54)Prospective26SequentialGynecologicStaging, restagingNSNSNSND
    Grueneisen (55)Retrospective24SimultaneousGynecologicRestagingNSNSNSND
    Pace (57)Prospective36SimultaneousBreastStaging, restaging———ND
    Grueneisen (58)Prospective49SimultaneousBreastStagingP < 0.05NS—PET/MRI superior for T-staging
    Total154
    • NS = nonsignificant; ND = no difference; — = not reported.

    • View popup
    TABLE 5

    Prostate Cancer

    StudyDesignPatients (n)PET/MRIPET ligandIndicationT-stagingN-stagingM-stagingSuperiority
    Wetter (64)Not stated36Simultaneous18F-cholineStaging, restaging———ND
    Afshar-Oromieh (62)Not stated20Simultaneous68Ga-PSMARestaging———ND
    Souvatzoglou (63)Prospective32Simultaneous11C-cholineStaging, restagingNSNSNSPET/MRI superior for prostatic and bone lesions
    Total88
    • NS = nonsignificant; ND = no difference; — = not reported.

    • View popup
    TABLE 6

    Lymphoma, Malignant Bone Disease, and Meningioma

    StudyDesignPatients (n)PET/MRICancer typeIndicationTNM-stagingSuperiority
    Heacock (69)Prospective28SimultaneousLymphomaStaging—ND
    Eiber (79)Retrospective119SimultaneousMalignant bone diseaseStaging, restaging—PET/MRI superior for allocation of bone lesions
    Beiderwellen (80)Prospective67SimultaneousMalignant bone diseaseStaging, restaging—ND
    Catalano (81)Prospective109SimultaneousMalignant bone diseaseStaging, restaging—PET/MRI superior for bone lesion detection
    Afshar-Oromieh (84)Prospective15SimultaneousMeningiomaStaging—ND
    Total338
    • NS = nonsignificant; ND = no difference; — = not reported.

    • View popup
    TABLE 7

    Mixed-Cancer Populations

    StudyDesignPatients (n)PET/MRIIndicationT-stagingN-stagingM-stagingSuperiority
    Drzezga (85)Prospective32SimultaneousStaging, restagingNSNSNSND
    Quick (86)Prospective80SimultaneousStaging, restaging———ND
    Al-Nabhani (87)Prospective50SimultaneousStaging———NS
    Catalano (88)Retrospective134SimultaneousStaging, restaging———PET/MRI superior for patient management (P < 0.001)
    Wiesmuller (89)Prospective46SimultaneousStaging, restaging———ND
    Appenzeller (90)Prospective63SequentialStaging, restaging———ND
    Jeong (91)Not stated12SimultaneousStaging, restaging———ND
    Huellner (92)Prospective106SequentialStaging, restagingNSNSNSND (more incidental findings by PET/CT)
    Schäfer (83)Prospective18SimultaneousStaging, restaging———ND
    Iagaru (10)Prospective36SimultaneousStaging, restaging———ND
    Tian (93)Retrospective285SimultaneousStaging, restaging———ND
    Heusch (94)Retrospective73SimultaneousStagingNSNSNDND
    Schaarschmidt (95)Retrospective61SimultaneousStagingNSNSNSND
    Total996
    • NS = nonsignificant; ND = no difference; — = not reported.

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Journal of Nuclear Medicine: 57 (3)
Journal of Nuclear Medicine
Vol. 57, Issue 3
March 1, 2016
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18F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients
Claudio Spick, Ken Herrmann, Johannes Czernin
Journal of Nuclear Medicine Mar 2016, 57 (3) 420-430; DOI: 10.2967/jnumed.115.158808

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18F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients
Claudio Spick, Ken Herrmann, Johannes Czernin
Journal of Nuclear Medicine Mar 2016, 57 (3) 420-430; DOI: 10.2967/jnumed.115.158808
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    • DESIGN OF PET/MRI SYSTEMS
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Keywords

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