Depiction and characterization of liver lesions in whole body [¹⁸F]-FDG PET/MRI

Eur J Radiol. 2013 Nov;82(11):e669-75. doi: 10.1016/j.ejrad.2013.07.027. Epub 2013 Aug 15.

Abstract

Objectives: To assess the value of PET/MRI with [(18)F]-FDG using a whole body protocol for the depiction and characterization of liver lesions in comparison to PET/CT.

Methods: 70 patients (31 women, 39 men) with solid tumors underwent [(18)F]-FDG PET/CT and followed by an additional PET/MRI using an integrated scanner. Two readers rated the datasets (PET/CT; PET/MRI) regarding conspicuity of hepatic lesions (4-point ordinal scale) and diagnostic confidence (5-point ordinal scale). Median scores for lesion conspicuity and diagnostic confidence were compared using Wilcoxon's rank sum test. Prior examinations, histopathology and clinical follow-up (116 ± 54 days) served as standard of reference.

Results: 36 of 70 (51%) patients showed liver lesions. Using PET/CT and PET/MRI all patients with liver metastases could correctly be identified. A total of 97 lesions were found (malignant n=26; benign n=71). For lesion conspicuity significantly higher scores were obtained for PET/MRI in comparison to PET/CT (p<0.001). Significantly better performance for diagnostic confidence was observed in PET/MRI, both for malignant as for benign lesions (p<0.001).

Conclusions: PET/MRI, even in the setting of a whole body approach, provides higher lesion conspicuity and diagnostic confidence compared to PET/CT and may therefore evolve as an attractive alternative in oncologic imaging.

Keywords: Liver metastases; PET/CT; PET/MRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Liver Neoplasms / diagnosis*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Whole Body Imaging / methods*
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18