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Diagnostic value of combined 18F-FDG PET/MRI for staging and restaging in paediatric oncology

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The present study compares the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and MRI to combined/registered 18F-FDG PET/MRI for staging and restaging in paediatric oncology.

Methods

Over 8 years and 2 months, 270 18F-FDG PET and 270 MRI examinations (mean interval 5 days) were performed in 132 patients with proven (n = 117) or suspected (n = 15) malignant disease: solid tumours (n = 64), systemic malignancy (n = 53) and benign disease (n = 15). A total of 259 suspected tumour lesions were analysed retrospectively during primary diagnosis and 554 lesions during follow-up. Image analysis was performed separately on each modality, followed by analysis of combined and registered 18F-FDG PET/MRI imaging.

Results

A total of 813 lesions were evaluated and confirmed by histopathology (n = 158) and/or imaging follow-up (n = 655) after 6 months. In the separate analysis of 18F-FDG PET and MRI, sensitivity was 86 %/94 % and specificity 85 %/38 %. Combined/registered 18F-FDG PET/MRI led to a sensitivity of 97 %/97 % and specificity of 81 %/82 %. False-positive results (18F-FDG PET n = 69, MRI n = 281, combined 18F-FDG PET/MRI n = 85, registered 18F-FDG PET/MRI n = 80) were due to physiological uptake or post-therapeutic changes. False-negative results (18F-FDG PET n = 50, MRI n = 20, combined 18F-FDG PET/MRI n = 11, registered 18F-FDG PET/MRI n = 11) were based on low uptake or minimal morphological changes. Examination-based evaluation during follow-up showed a sensitivity/specificity of 91 %/81 % for 18F-FDG PET, 93 %/30 % for MRI and 96 %/72 % for combined 18F-FDG PET/MRI.

Conclusion

For the detection of single tumour lesions, registered 18F-FDG PET/MRI proved to be the methodology of choice for adequate tumour staging. In the examination-based evaluation, MRI alone performed better than 18F-FDG PET and combined/registered imaging during primary diagnosis. At follow-up, however, the examination-based evaluation demonstrated a superiority of 18F-FDG PET alone.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Ludwig Maximilians University of Munich, Ziemssenstraße 1, 80336, Munich, Germany

    Thomas Pfluger, Henriette I. Melzer, Wolfgang P. Mueller & Peter Bartenstein

  2. Department of Radiology, Ludwig Maximilians University of Munich, Munich, Germany

    Eva Coppenrath

  3. Department of Paediatric Oncology/Haematology, Ludwig Maximilians University of Munich, Munich, Germany

    Michael H. Albert & Irene Schmid

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  1. Thomas Pfluger
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  2. Henriette I. Melzer
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  3. Wolfgang P. Mueller
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Correspondence to Henriette I. Melzer.

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Pfluger, T., Melzer, H.I., Mueller, W.P. et al. Diagnostic value of combined 18F-FDG PET/MRI for staging and restaging in paediatric oncology. Eur J Nucl Med Mol Imaging 39, 1745–1755 (2012). https://doi.org/10.1007/s00259-012-2228-3

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  • DOI: https://doi.org/10.1007/s00259-012-2228-3

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