PET/CT in oncology: for which tumours is it the reference standard?

Collins, Conor D

doi:10.1102/1470-7330.2007.9008

Cited by 41 publications

(30 citation statements)

References 131 publications

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“…The introduction of combined PET/CT imaging in 1998 was a major breakthrough in hybrid imaging technology (2), and it is now an important staging modality in oncology patients (3)(4)(5)(6). Similarly, the recent introduction of truly integrated PET/MR imaging scanners has generated much interest.…”

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confidence: 99%

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

et al. 2013

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The aim of this study was to prospectively compare whole-body PET/MR imaging and PET/CT, qualitatively and quantitatively, in oncologic patients and assess the confidence and degree of inter-and intraobserver agreement in anatomic lesion localization. Methods: Fifty patients referred for staging with known cancers underwent PET/CT with low-dose CT for attenuation correction immediately followed by PET/MR imaging with 2-point Dixon attenuation correction. PET/CT scans were obtained according to standard protocols (56 6 20 min after injection of an average 367 MBq of 18 F-FDG, 150 MBq of 68 Ga-DOTATATE, or 333.8 MBq of 18 F-fluoro-ethyl-choline; 2.5 min/bed position). PET/MR was performed with 5 min/bed position. Three dual-accredited nuclear medicine physicians/radiologists identified the lesions and assigned each to an exact anatomic location. The image quality, alignment, and confidence in anatomic localization of lesions were scored on a scale of 1-3 for PET/CT and PET/MR imaging. Quantitative analysis was performed by comparing the standardized uptake values. Intraclass correlation coefficients and the Wilcoxon signed-rank test were used to assess intra-and interobserver agreement in image quality, alignment, and confidence in lesion localization for the 2 modalities. Results: Two hundred twenty-seven tracer-avid lesions were identified in 50 patients. Of these, 225 were correctly identified on PET/CT and 227 on PET/MR imaging by all 3 observers. The confidence in anatomic localization improved by 5.1% when using PET/MR imaging, compared with PET/CT. The mean percentage interobserver agreement was 96% for PET/CT and 99% for PET/MR imaging, and intraobserver agreement in lesion localization across the 2 modalities was 93%. There was 10% (5/50 patients) improvement in local staging with PET/MR imaging, compared with PET/CT. Conclusion: In this first study, we show the effectiveness of whole-body PET/MR imaging in oncology. There is no statistically significant difference between PET/MR imaging and PET/CT in respect of confidence and degree of inter-and intraobserver agreement in anatomic lesion localization. The PET data on both modalities were similar; however, the observed superior soft-tissue resolution of MR imaging in head and neck, pelvis, and colorectal cancers and of CT in lung and mediastinal nodal disease points to future tailored use in these locations.

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confidence: 99%

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

et al. 2013

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“…2). N staging FDG PET/CT is more accurate than CT alone in the assessment of N stage in different malignant diseases, and shows significantly higher accuracy than whole-body MRI in staging lymph node metastatic spread [49,50]. This advantage of FDG PET/CT over MRI and CT is due to the metabolic data: PET has the capability to detect viable tumor tissue in metastatic lymph nodes independently of their size.…”

Section: Whole-body Fdg Pet/mrimentioning

confidence: 99%

Whole-body PET/MRI in oncology: current status and clinical applications

Pace

Nicolai

Aiello

et al. 2013

Clin Transl Imaging

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In oncology, diagnostic imaging plays a major role in staging, therapy assessment and in the evaluation of tumor biology. Multimodality imaging, and more specifically positron emission tomography/computed tomography (PET/CT), has matured into an important imaging tool. The recent introduction of the integrated whole-body PET/ magnetic resonance imaging (MRI) represents the addition of a promising methodology in clinical practice. Combining the metabolic data of PET with the anatomical and functional information provided by MRI and fMRI may further improve the diagnostic value of each method alone. Although the literature is still limited, data indicate a potential advantage of PET/MRI over PET/CT in all the indications where MRI is superior to CT, as well as in the evaluation of tumor biology. Integrated PET/MRI might be performed in addition to the existing imaging modality in specific regions. Moreover, integrated PET/MRI is an alternative to PET/CT when a low radiation dose is required, i.e. in children and in repeated imaging. In the rapidly evolving field of diagnostic imaging, the role of a new modality should be accurately evaluated. Further studies are needed to test the diagnostic accuracy of PET/MRI in different oncology indications. Whether PET/MRI will replace PET/CT or be a complementary methodology and whether it represents true diagnostic progress remains to be evaluated, also taking into account economic considerations.

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“…The FDG PET/CT is more accurate than just a CT in the assessment of N stage of various types of cancer [42]. The advantage of the FDG PET/CT scan over a CT scan is the acquisition of additional information on lymph node metabolism.…”

Section: Reviewmentioning

confidence: 99%