PET/MRI in head and neck cancer: initial experience

Abstract

PurposeTo evaluate the feasibility of PET/MRI (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for initial staging of head and neck cancer.MethodsThe study group comprised 20 patients (16 men, 4 women) aged between 52 and 81 years (median 64 years) with histologically proven squamous cell carcinoma of the head and neck region. The patients underwent a PET scan on a conventional scanner and a subsequent PET/MRI examination on a whole-body hybrid system. FDG was administered intravenously prior to the conventional PET scan (267–395 MBq FDG, 348 MBq on average). The maximum standardized uptake values (SUVmax) of the tumour and of both cerebellar hemispheres were determined for both PET datasets. The numbers of lymph nodes with increased FDG uptake were compared between the two PET datasets.ResultsNo MRI-induced artefacts where observed in the PET images. The tumour was detected by PET/MRI in 17 of the 20 patients, by PET in 16 and by MRI in 14. The PET/MRI examination yielded significantly higher SUVmax than the conventional PET scanner for both the tumour (p < 0.0001) and the cerebellum (p = 0.0009). The number of lymph nodes with increased FDG uptake detected using the PET dataset from the PET/MRI system was significantly higher the number detected by the stand-alone PET system (64 vs. 39, p = 0.001).ConclusionThe current study demonstrated that PET/MRI of the whole head and neck region is feasible with a whole-body PET/MRI system without impairment of PET or MR image quality.

Qualitative and Quantitative Performance of18F-FDG-PET/MRI versus18F-FDG-PET/CT in Patients with Head and Neck Cancer

“…Furthermore, the SUVs in tumor and the cerebellum were significantly higher when comparing PET/MR imaging versus stand-alone PET. 21 This observation is in accordance with our study in which the absolute SUV max were higher in PET/MR imaging versus PET/CT as well. In comparison with their study, the current study compared whole-body 18 F-FDG-PET/MR imaging versus 18 F-FDG-PET/CT instead of a stand-alone PET.…”

“…This study and others demonstrate that that the scan-ning time in PET/MR imaging is slightly longer compared with PET/CT. 21 This may change in the future when a full diagnostic MR imaging protocol is integrated into the PET/MR imaging workflow.…”

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

“…No significant difference was found in detection rate both on a lesion and on a patient basis, and quantitative evaluation showed high correlation between SUVs obtained by PET/MRI and PET/CT both in lesions and in background tissue [93]. A high concordance (ranging from 88 to 99 %) between PET/MRI and PET/CT on both a patient and a lesion basis was observed by other authors [96,97].…”

PET/MRI: Applications in Clinical Imaging

“…For both designs, workflow suggestions are now available [4 • , 20 • , [21][22][23]. The fundamental decision in both instances is, however, if partial MRI, focused on an area or organ of interest, or whole-body MRI should be performed, or both.…”