RT Journal Article
SR Electronic
T1 PET/MRI Versus PET/CT for Whole-Body Staging: Results from a Single-Center Observational Study on 1,003 Sequential Examinations
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1131
OP 1136
DO 10.2967/jnumed.119.233940
VO 61
IS 8
A1 Martin, Ole
A1 Schaarschmidt, Benedikt M.
A1 Kirchner, Julian
A1 Suntharalingam, Saravanabavaan
A1 Grueneisen, Johannes
A1 Demircioglu, Aydin
A1 Heusch, Philipp
A1 Quick, Harald H.
A1 Forsting, Michael
A1 Antoch, Gerald
A1 Herrmann, Ken
A1 Umutlu, Lale
YR 2020
UL http://jnm.snmjournals.org/content/61/8/1131.abstract
AB Our purpose was to investigate differences between PET/MRI and PET/CT in lesion detection and classification in oncologic whole-body examinations and to investigate radiation exposure differences between the 2 modalities. Methods: In this observational single-center study, 1,003 oncologic examinations (918 patients; mean age, 57.8 ± 14.4 y) were included. Patients underwent PET/CT and subsequent PET/MRI (149.8 ± 49.7 min after tracer administration). Examinations were reviewed by radiologists and nuclear medicine physicians in consensus. Additional findings, characterization of indeterminate findings on PET/CT, and missed findings on PET/MRI, including their clinical relevance and effective dose of both modalities, were investigated. The McNemar test was used to compare lesion detection between the 2 hybrid imaging modalities (P < 0.001, indicating statistical significance). Results: Additional information on PET/MRI was reported for 26.3% (264/1,003) of examinations, compared with PET/CT (P < 0.001). Of these, additional malignant findings were detected in 5.3% (53/1,003), leading to a change in TNM staging in 2.9% (29/1,003) due to PET/MRI. Definite lesion classification of indeterminate PET/CT findings was possible in 11.1% (111/1,003) with PET/MRI. In 2.9% (29/1,003), lesions detected on PET/CT were not visible on PET/MRI. Malignant lesions were missed in 1.2% (12/1,003) on PET/MRI, leading to a change in TNM staging in 0.5% (5/1,003). The estimated mean effective dose for whole-body PET/CT amounted to 17.6 ± 8.7 mSv, in comparison to 3.6 ± 1.4 mSv for PET/MRI, resulting in a potential dose reduction of 79.6% (P < 0.001). Conclusion: PET/MRI facilitates staging comparable to that of PET/CT and improves lesion detectability in selected cancers, potentially helping to promote fast, efficient local and whole-body staging in 1 step, when additional MRI is recommended. Furthermore, younger patients may benefit from the reduced radiation exposure of PET/MRI.