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The usefulness of 18F-FDG PET/MRI fusion image in diagnosing pancreatic tumor: comparison with 18F-FDG PET/CT

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Abstract

Purpose

This study aimed at demonstrating the feasibility of retrospectively fused 18F FDG-PET and MRI (PET/MRI fusion image) in diagnosing pancreatic tumor, in particular differentiating malignant tumor from benign lesions. In addition, we evaluated additional findings characterizing pancreatic lesions by FDG-PET/MRI fusion image.

Methods

We analyzed retrospectively 119 patients: 96 cancers and 23 benign lesions. FDG-PET/MRI fusion images (PET/T1 WI or PET/T2WI) were made by dedicated software using 1.5 Tesla (T) MRI image and FDG-PET images. These images were interpreted by two well-trained radiologists without knowledge of clinical information and compared with FDG-PET/CT images. We compared the differential diagnostic capability between PET/CT and FDG-PET/MRI fusion image. In addition, we evaluated additional findings such as tumor structure and tumor invasion.

Results

FDG-PET/MRI fusion image significantly improved accuracy compared with that of PET/CT (96.6 vs. 86.6 %). As additional finding, dilatation of main pancreatic duct was noted in 65.9 % of solid types and in 22.6 % of cystic types, on PET/MRI-T2 fusion image. Similarly, encasement of adjacent vessels was noted in 43.1 % of solid types and in 6.5 % of cystic types. Particularly in cystic types, intra-tumor structures such as mural nodule (35.4 %) or intra-cystic septum (74.2 %) were detected additionally. Besides, PET/MRI-T2 fusion image could detect extra benign cystic lesions (9.1 % in solid type and 9.7 % in cystic type) that were not noted by PET/CT.

Conclusions

In diagnosing pancreatic lesions, FDG-PET/MRI fusion image was useful in differentiating pancreatic cancer from benign lesions. Furthermore, it was helpful in evaluating relationship between lesions and surrounding tissues as well as in detecting extra benign cysts.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Miyazaki University, 5200 Kihara, Kiyotake, Miyazaki-city, Miyazaki Prefecture, 889-1692, Japan

    Shigeki Nagamachi, Ryuichi Nishii, Hideyuki Wakamatsu, Youichi Mizutani, Shogo Kiyohara, Seigo Fujita, Shigemi Futami, Tatefumi Sakae, Eiji Furukoji, Shozo Tamura & Hideo Arita

  2. Department of the 1st Surgery, Faculty of Medicine, Miyazaki University, 5200 Kihara, Kiyotake, Miyazaki-city, Miyazaki Prefecture, 889-1692, Japan

    Kazuo Chijiiwa

  3. Faculty of Health Science, School of Medicine, Kanazawa University, Kanazawa, Ishikawa Prefecture, 920-8640, Japan

    Keiichi Kawai

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  1. Shigeki Nagamachi
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Correspondence to Shigeki Nagamachi.

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Nagamachi, S., Nishii, R., Wakamatsu, H. et al. The usefulness of 18F-FDG PET/MRI fusion image in diagnosing pancreatic tumor: comparison with 18F-FDG PET/CT. Ann Nucl Med 27, 554–563 (2013). https://doi.org/10.1007/s12149-013-0719-3

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  • DOI: https://doi.org/10.1007/s12149-013-0719-3

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