Feasibility and diagnostic performance of hybrid PET/MRI compared with PET/CT for gynecological malignancies: a prospective pilot study

Schwartz, Melissa; Gavane, Somali; Bou-Ayache, Jad; Kolev, Valentin; Zakashansky, Konstantin; Prasad-Hayes, Monica; Taouli, Bachir; Chuang, Linus; Kostakoğlu, Lale

doi:10.1007/s00261-018-1665-2

Cited by 31 publications

(23 citation statements)

References 22 publications

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“…Sensitivity, specificity, and diagnostic accuracy for nodal disease were 91, 94, and 93%, respectively. The results of subsequent studies support the high diagnostic potential of hybrid PET/MRI in cervical cancer staging ( 12 , 26 – 28 ).…”

Section: Review Of Literaturementioning

confidence: 52%

“…We have identified 26 studies consisting of a total of 801 subjects that reported on the diagnostic value of fused or integrated PET/MRI for the clinical management of female pelvic malignancies, Table 1 . Of these, 17 studies were based on an integrated PET/MRI system ( 12 – 18 , 26 – 29 , 31 – 34 , 36 , 37 ), and nine studies applied co-registered (fused) PET/MRI data ( 19 – 25 , 30 , 35 ). A total of 15 studies with 413 subjects were for staging ( 12 – 25 , 27 , 36 ); six studies with 187 subjects for restaging ( 31 – 35 , 37 ); and six studies of 175 subjects of mixed staging and restaging ( 26 – 30 , 36 ).…”

Section: Review Of Literaturementioning

confidence: 99%

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Diagnostic Value of FDG PET/MRI in Females With Pelvic Malignancy—A Systematic Review of the Literature

et al. 2020

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Hybrid imaging with F-18 fludeoxyglucose positron emission tomography/magnetic resonance imaging (FDG PET/MRI) has increasing clinical applications supplementing conventional ultrasound, CT, and MRI imaging as well as hybrid PET/CT imaging in assessing cervical, endometrial, and ovarian cancer. This article summarizes the existing literature and discusses the emerging role of hybrid PET/MRI in gynecologic malignancies. Thus, far, the published literature on the applications of FDG PET/MRI shows that it can have a significant impact on patient management by improving the staging of the cancers compared with PET/CT, influencing clinical decision and treatment strategy. For disease restaging, current literature indicates that PET/MRI performs equivalently to PET/CT. There appears to be a mild-moderate inverse correlation between standard-uptake-value (SUV) and apparent-diffusion-coefficient (ADC) values, which could be used to predict tumor grading and risk stratification. It remains to be seen as to whether multi-parametric PET/MRI imaging could prove valuable for prognostication and outcome. PET/MRI provides the opportunity for reduced radiation exposure, which is particularly relevant for a young female in need of multiple scans for treatment monitoring and follow-up. Fast acquisition protocols and optimized methods for attenuation correction are still evolving. Major limitations of PET/MRI remains such as suboptimal detection of small pulmonary nodules and lack of utility for radiation treatment planning, which pose an impediment in making PET/MRI a viable one-stop-shop imaging option to compete with PET/CT.

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Section: Review Of Literaturementioning

confidence: 52%

Section: Review Of Literaturementioning

confidence: 99%

Diagnostic Value of FDG PET/MRI in Females With Pelvic Malignancy—A Systematic Review of the Literature

et al. 2020

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“…Simultaneous PET/MRI images were obtained using an integrated PET/MRI scanner BiographmMR (Siemens Healthcare Sector, Erlangen, Germany) as previously reported (Schwartz et al, 2018). Patients fasted for at least 6 h before tracer injection.…”

Section: Methodsmentioning

confidence: 99%

Comparison of integrated PET/MRI with PET/CT in evaluation of endometrial cancer: a retrospective analysis of 81 cases

Bian¹,

Wang²,

Gong³

et al. 2019

PeerJ

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Background The objective of this study was to compare the diagnostic value of integrated PET/MRI with PET/CT for assessment of regional lymph node metastasis and deep myometrial invasion detection of endometrial cancer. Methods Eighty-one patients with biopsy-proven endometrial cancer underwent preoperative PET/CT (n = 37) and integrated PET/MRI (n = 44) for initial staging. The diagnostic performance of PET/CT and integrated PET/MRI for assessing the extent of the primary tumor and metastasis to the regional lymph nodes was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. McNemar’s test was employed for statistical analysis. Results Integrated PET/MRI and PET/CT both detected 100% of the primary tumors. Integrated PET/MRI proved significantly more sensitivity and specificity than PET/CT in regional lymph node metastasis detection (P = 0.015 and P < 0.001, respectively). The overall accuracy of myometrial invasion detection for PET/CT and Integrated PET/MRI was 45.9% and 81.8%, respectively. Integrated PET/MRI proved significantly more accurate than PET/CT (P < 0.001). Conclusion Integrated PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for the assessment of the lymph node metastasis and myometrial invasion in patients with endometrial cancer.

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“…In a prospective study of 18 gynecological cancer cases including cervical cancer and high-risk endometrial cancer, PET/MRI detected all primary tumors and regional lymph nodes as well as PET/CT. In addition, PET/MRI had higher sensitivity for parametrial and bladder invasion than PET/CT 19 . In another prospective study of 26 gynecological cancer cases including seven cervical cancer cases and 12 ovarian cancer cases, PET/MRI and PET/CT could equally detect regional lymph nodes metastasis 20 .…”

Section: Discussionmentioning

confidence: 91%

“…Recently, it has been reported that FDG-PET imaging combined with CT or MRI are important tools to detect the spread of many cancers. Some groups have reported the e cacy of FDG-PET examination for cervical cancer 16,[18][19][20] . In a meta-analysis, the sensitivity and speci city of PET for lymph node metastases were 74.7% (95% CI 63.3-84.0) and 97.6% (95% CI 95.4-98.9), respectively.…”

Section: Discussionmentioning

confidence: 99%

PET/MR Imaging for the Evaluation of Cervical Cancer During Pregnancy

Ishiguro

Nishikawa²,

Ishii

et al. 2020

Preprint

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Background: To assess the diagnostic value of positron emission tomography/magnetic resonance imaging (PET/MRI) for cervical cancer propagation before surgery, especially in pregnant women.Methods: 18F Fluorodeoxyglucose (FDG)-PET/MRI was performed in seven pregnant cervical cancer patients (28 - 34 years old) at 9-18 gestational weeks. In case #5, a second PET/MRI was performed at 24 gestational weeks. Results: Of seven FDG-PET/MRI examination series in six cases (cases #1-#6), FDG-PET/MR imaging could detect cervical tumors with abnormal FDG accumulation; these tumors were confirmed with a standardized uptake value max (SUV max) titer of 4.5 - 16. A second PET/MRI examination in case #5 revealed the same SUV max titer as the first examination. In these six imaging series (cases #1-#5), there were no signs of cancer metastasis to the parametrium and lymph nodes. However, in case #6, abnormal FDG accumulation in the left parametrial lymph nodes was also detectable. Pathological examination showed lymph node metastasis in case #6. In case #7, PET/MRI could not detect any abnormal FDG accumulation in the cervix and other sites. Cone biopsy demonstrated only micro-invasive squamous cell carcinoma. After treatment for cervical cancer, all seven patients have had no recurrence of disease within the follow-up period (2.4 – 5.2 years), and their children have developed appropriately.Conclusion: PET/MRI is an effective and relatively safe imaging tool to evaluate cervical cancer progression in pregnancy.

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Feasibility and diagnostic performance of hybrid PET/MRI compared with PET/CT for gynecological malignancies: a prospective pilot study

Abstract: PET/MRI is feasible and has at least comparable diagnostic ability to PET/CT for identification of primary cervical and endometrial tumors and regional metastases. PET/MRI may be superior to PET/CT for initial radiographic assessment of cervical cancers.

Cited by 31 publications

References 22 publications

Diagnostic Value of FDG PET/MRI in Females With Pelvic Malignancy—A Systematic Review of the Literature

Diagnostic Value of FDG PET/MRI in Females With Pelvic Malignancy—A Systematic Review of the Literature

Comparison of integrated PET/MRI with PET/CT in evaluation of endometrial cancer: a retrospective analysis of 81 cases

PET/MR Imaging for the Evaluation of Cervical Cancer During Pregnancy

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