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Diagnostic accuracy of whole-body PET/MRI and whole-body PET/CT for TNM staging in oncology

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

Abstract

Purpose

In various tumours PET/CT with [18F]FDG is widely accepted as the diagnostic standard of care. The purpose of this study was to compare a dedicated [18F]FDG PET/MRI protocol with [18F]FDG PET/CT for TNM staging in a cohort of oncological patients.

Methods

A dedicated [18F]FDG PET/MRI protocol was performed in 73 consecutive patients (mean age of 59 years, range 21 – 85 years) with different histologically confirmed solid primary malignant tumours after a routine clinical FDG PET/CT scan (60 min after injection of 295 ± 45 MBq [18F]FDG). TNM staging according to the 7th edition of the AJCC Cancer Staging Manual was performed by two readers in separate sessions for PET/CT and PET/MRI images. Assessment of the primary tumour and nodal and distant metastases with FDG PET/CT and FDG PET/MRI was based on qualitative and quantitative analyses. Histopathology, and radiological and clinical follow-up served as the standards of reference. A McNemar test was performed to evaluate the differences in diagnostic performance between the imaging procedures.

Results

From FDG PET/CT and FDG PET/MRI T stage was correctly determined in 22 (82 %) and 20 (74 %) of 27 patients, N stage in 55 (82 %) and 56 (84 %) of 67 patients, and M stage in 32 (76 %) and 35 (83 %) of 42 patients, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for lymph node metastases were 65 %, 94 %, 79 %, 89 % and 87 % for PET/CT, and 63 %, 94 %, 80 %, 87 % and 85 % for PET/MRI. The respective values for the detection of distant metastases were 50 %, 82 %, 40 %, 88 % and 76 % for PET/CT, and 50 %, 91 %, 57 %, 89 % and 83 % for PET/MRI. Differences between the two imaging modalities were not statistically significant (P > 0.05).

Conclusion

According to our results, FDG PET/CT and FDG PET/MRI are of equal diagnostic accuracy for TNM staging in patients with solid tumours.

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Authors and Affiliations

  1. Medical Faculty, Department of Diagnostic and Interventional Radiology, University Duesseldorf,, Moorenstr. 5, 40225, Duesseldorf, Germany

    Philipp Heusch, Benedikt Schaarschmidt, Rupika Sivanesapillai & Christian Buchbender

  2. Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, 45147, Essen, Germany

    Philipp Heusch, Felix Nensa & Karsten Beiderwellen

  3. Medical Faculty, Department of Nuclear Medicine, University Duisburg-Essen, 45147, Essen, Germany

    Benedikt Gomez & Verena Ruhlmann

  4. Medical Faculty, Department of Medical Oncology, University Duisburg-Essen, Essen, Germany

    Jens Köhler

  5. Medical Faculty, Institute of Pathology, University Duisburg-Essen, Essen, Germany

    Henning Reis

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  1. Philipp Heusch
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  2. Felix Nensa
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Correspondence to Philipp Heusch.

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Heusch, P., Nensa, F., Schaarschmidt, B. et al. Diagnostic accuracy of whole-body PET/MRI and whole-body PET/CT for TNM staging in oncology. Eur J Nucl Med Mol Imaging 42, 42–48 (2015). https://doi.org/10.1007/s00259-014-2885-5

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  • DOI: https://doi.org/10.1007/s00259-014-2885-5

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