Protocol requirements and diagnostic value of PET/MR imaging for liver metastasis detection.

Details

Serval ID
serval:BIB_6BB3298FA142
Type
Article: article from journal or magazin.
Collection
Publications
Title
Protocol requirements and diagnostic value of PET/MR imaging for liver metastasis detection.
Journal
European Journal of Nuclear Medicine and Molecular Imaging
Author(s)
Reiner C.S., Stolzmann P., Husmann L., Burger I.A., Hüllner M.W., Schaefer N.G., Schneider P.M., von Schulthess G.K., Veit-Haibach P.
ISSN
1619-7089 (Electronic)
ISSN-L
1619-7070
Publication state
Published
Issued date
2014
Volume
41
Number
4
Pages
649-658
Language
english
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
PURPOSE: To compare the accuracy of PET/MR imaging with that of FDG PET/CT and to determine the MR sequences necessary for the detection of liver metastasis using a trimodality PET/CT/MR set-up.
METHODS: Included in this single-centre IRB-approved study were 55 patients (22 women, age 61 ± 11 years) with suspected liver metastases from gastrointestinal cancer. Imaging using a trimodality PET/CT/MR set-up (time-of-flight PET/CT and 3-T whole-body MR imager) comprised PET, low-dose CT, contrast-enhanced (CE) CT of the abdomen, and MR with T1-W/T2-W, diffusion-weighted (DWI), and dynamic CE imaging. Two readers evaluated the following image sets for liver metastasis: PET/CT (set A), PET/CECT (B), PET/MR including T1-W/T2-W (C), T1-W/T2-W with either DWI (D) or CE imaging (E), and a combination (F). The accuracy of each image set was determined by receiver-operating characteristic analysis using image set B as the standard of reference.
RESULTS: Of 120 liver lesions in 21/55 patients (38%), 79 (66%) were considered malignant, and 63/79 (80%) showed abnormal FDG uptake. Accuracies were 0.937 (95% CI 89.5 - 97.9%) for image set A, 1.00 (95% CI 99.9 - 100.0%) for set C, 0.998 (95% CI 99.4 - 100.0%) for set D, 0.997 (95% CI 99.3 - 100.0%) for set E, and 0.995 (95% CI 99.0 - 100.0%) for set F. Differences were significant for image sets D - F (P < 0.05) when including lesions without abnormal FDG uptake. As shown by follow-up imaging after 50 - 177 days, the use of image sets D and both sets E and F led to the detection of metastases in one and three patients, respectively, and further metastases in the contralateral lobe in two patients negative on PET/CECT (P = 0.06).
CONCLUSION: PET/MR imaging with T1-W/T2-W sequences results in similar diagnostic accuracy for the detection of liver metastases to PET/CECT. To significantly improve the characterization of liver lesions, we recommend the use of dynamic CE imaging sequences. PET/MR imaging has a diagnostic impact on clinical decision making.
Keywords
Aged, Clinical Protocols, Female, Gastrointestinal Neoplasms/pathology, Humans, Liver Neoplasms/diagnosis, Liver Neoplasms/radiography, Magnetic Resonance Imaging, Male, Middle Aged, Multimodal Imaging, Positron-Emission Tomography, Sensitivity and Specificity, Tomography, X-Ray Computed
Pubmed
Create date
17/06/2015 14:49
Last modification date
21/08/2019 5:36
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