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Use of diffusion-weighted imaging (DWI) in PET/MRI for head and neck cancer evaluation

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

Abstract

Objective

The purpose of this study was to analyze whether diffusion-weighted imaging (DWI) adds significant information to positron emission tomography/magnetic resonance imaging (PET/MRI) on lesion detection and characterization in head and neck cancers.

Methods

Seventy patients with different head and neck cancers were enrolled in this prospective study. All patients underwent sequential contrast-enhanced (ce) PET/computed tomography (CT) and cePET/MRI using a tri-modality PET/CT-MR setup either for staging or re-staging. First, the DWI alone was evaluated, followed by the PET/MRI with conventional sequences, and in a third step, the PET/MRI with DWI was evaluated. McNemar’s test was used to evaluate differences in the accuracy of PET/MRI with and without DWI compared to the standard of reference.

Results

One hundred eighty-eight (188) lesions were found, and of those, 118 (62.8 %) were malignant and 70 (37.2 %) were benign. PET/MRI without DWI had a higher accuracy in detecting malignant lesions than DWI alone (86.8 % vs. 60.6 %, p < 0.001). PET/MRI combined with DWI detected 120 concurrent lesions (89 malignant and 31 benign), PET/MRI alone identified 48 additional lesions (20 malignant and 28 benign), and DWI alone detected 20 different lesions (nine malignant and 11 benign). However, lesions detected on DWI did not change overall staging. SUV maximum and mean were significantly higher in malignant lesions than in benign lesions. DWI parameters between malignant and benign lesions were not statistically different.

Conclusion

The use of DWI as part of PET/MRI to evaluate head and neck cancers does not provide remarkable information. Thus, the use of DWI might not be needed in clinical PET/MRI protocols for the staging or restaging of head and neck cancers.

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Disclosures

This research project was supported by an institutional research grant from GE Healthcare. Patrick Veit-Haibach received IIS Grants from Bayer Healthcare and Siemens Medical Solutions, and speaker fees from GE Healthcare. Gustav von Schulthess is a grant recipient of GE Healthcare funding and receives speaker fees from GE Healthcare. The other authors declare no other conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Radiology, Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland

    Marcelo A. Queiroz, Martin Hüllner, Felix Kuhn, Gustav von Schulthess & Patrick Veit-Haibach

  2. Department of Medical Radiology, Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland

    Felix Kuhn & Patrick Veit-Haibach

  3. Department of Medical Radiology, Neuroradiology, University Hospital Zurich, Zurich, Switzerland

    Martin Hüllner & Spyros Kollias

  4. Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland

    Gerhardt Huber & Christian Meerwein

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  1. Marcelo A. Queiroz
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Correspondence to Marcelo A. Queiroz.

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Queiroz, M.A., Hüllner, M., Kuhn, F. et al. Use of diffusion-weighted imaging (DWI) in PET/MRI for head and neck cancer evaluation. Eur J Nucl Med Mol Imaging 41, 2212–2221 (2014). https://doi.org/10.1007/s00259-014-2867-7

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  • DOI: https://doi.org/10.1007/s00259-014-2867-7

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