RT Journal Article
SR Electronic
T1 Comparative Performance of <sup>18</sup>F-FDG PET/MRI and <sup>18</sup>F-FDG PET/CT in Detection and Characterization of Pulmonary Lesions in 121 Oncologic Patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 582
OP 586
DO 10.2967/jnumed.115.167486
VO 57
IS 4
A1 Lino M. Sawicki
A1 Johannes Grueneisen
A1 Christian Buchbender
A1 Benedikt M. Schaarschmidt
A1 Benedikt Gomez
A1 Verena Ruhlmann
A1 Axel Wetter
A1 Lale Umutlu
A1 Gerald Antoch
A1 Philipp Heusch
YR 2016
UL http://jnm.snmjournals.org/content/57/4/582.abstract
AB Our objective was to compare 18F-FDG PET/MRI (performed using a contrast-enhanced T1-weighted fat-suppressed volume-interpolated breath-hold examination [VIBE]) with 18F-FDG PET/CT for detecting and characterizing lung lesions in oncologic patients. Methods: In 121 oncologic patients with 241 lung lesions, PET/MRI was performed after PET/CT in a single-injection protocol (260 ± 58 MBq of 18F-FDG). The detection rates were computed for MRI, the PET component of PET/CT, and the PET component of PET/MRI in relation to the CT component of PET/CT. Wilcoxon testing was used to assess differences in lesion contrast (4-point scale) and size between morphologic datasets and differences in image quality (4-point scale), SUVmean, SUVmax, and characterization (benign/malignant) between PET/MRI and PET/CT. Correlation was determined using the Pearson coefficient (r) for SUV and size and the Spearman rank coefficient (ρ) for contrast. Results: The detection rates for MRI, the PET component of PET/CT, and the PET component of PET/MRI were 66.8%, 42.7%, and 42.3%, respectively. There was a strong correlation in size (r = 0.98) and SUV (r = 0.91) and a moderate correlation in contrast (ρ = 0.48). Image quality was better for PET/CT than for PET/MRI (P &lt; 0.001). Lesion measurements were smaller for MRI than for CT (P &lt; 0.001). SUVmax and SUVmean were significantly higher for PET/MRI than for PET/CT (P &lt; 0.001 each). There was no significant difference in lesion contrast (P = 0.11) or characterization (P = 0.076). Conclusion: In the detection and characterization of lung lesions 10 mm or larger, 18F-FDG PET/MRI and 18F-FDG PET/CT perform comparably. Lesion size, SUV and characterization correlate strongly between the two modalities. However, the overall detection rate of PET/MRI remains inferior to that of PET/CT because of the limited ability of MRI to detect lesions smaller than 10 mm. Thus, thoracic staging with PET/MRI bears a risk of missing small lung metastases.