PET/MRI with diagnostic MR sequences vs PET/CT in the detection of abdominal and pelvic cancer

Xin, Jun; Ma, Qingtian; Guo, Qiyong; Sun, Hongzan; Zhang, Shaomin; Liu, Changping; Zhai, Wei

doi:10.1016/j.ejrad.2016.01.010

Cited by 27 publications

(36 citation statements)

References 33 publications

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“…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%

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: 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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“…[916] The range of sensitivity of ld PET/CT as reported in the remainder four studies was 80.6%–96.0% based on Tanizaki et al . [17] and Minamimoto et al .,[18] respectively.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…[91216] Tsuboyama et al . analyzed separately as well as with consensus MRI findings compared to PET/CT findings; however, it did not involve PET/MRI image fusion.…”

Section: Evidence Synthesismentioning

confidence: 99%

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Systematic review on the accuracy of positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging in the management of ovarian cancer: Is functional information really needed?

et al. 2017

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Ovarian cancer (OC) often presents at an advanced stage with frequent relapses despite optimal treatment; thus, accurate staging and restaging are required for improving treatment outcomes and prognostication. Conventionally, staging of OC is performed using contrast-enhanced computed tomography (CT). Nevertheless, recent advances in the field of hybrid imaging have made positron emission tomography/CT (PET/CT) and PET/magnetic resonance imaging (PET/MRI) as emerging potential noninvasive imaging tools for improved management of OC. Several studies have championed the role of PET/CT for the detection of recurrence and prognostication of OC. We provide a systematic review and meta-analysis of the latest publications regarding the role of molecular imaging in the management of OC. We retrieved 57 original research articles with one article having overlap in both diagnosis and staging; 10 articles (734 patients) regarding the role of PET/CT in diagnosis of OC; 12 articles (604 patients) regarding staging of OC; 22 studies (1429 patients) for detection of recurrence; and 13 articles for prognostication and assessment of treatment response. We calculated pooled sensitivity and specificity of PET/CT performance in various aspects of imaging of OC. We also discussed the emerging role of PET/MRI in the management of OC. We aim to give the readers and objective overview on the role of molecular imaging in the management of OC.

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“…A number of studies reported that 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]FDG) PET/MRI has the potential to qualitatively and quantitatively improve tumor characterization in breast cancer [2,3]. Xin et al [4] also reported that PET/MRI could provide good image quality suitable for the detection of abdominal and pelvic tumors. Using PET/MRI, improved diagnostic performance in patients with colorectal cancer liver metastases was also observed, compared with PET or CT imaging [5].…”

Section: Introductionmentioning

confidence: 99%

Impact of Tissue Classification in MRI-Guided Attenuation Correction on Whole-Body Patlak PET/MRI

et al. 2019

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Purpose: The aim of this work is to investigate the impact of tissue classification in magnetic resonance imaging (MRI)-guided positron emission tomography (PET) attenuation correction (AC) for whole-body (WB) Patlak net uptake rate constant (K i ) imaging in PET/MRI studies. Procedures: WB dynamic PET/CT data were acquired for 14 patients. The CT images were utilized to generate attenuation maps (μ-map CTAC ) of continuous attenuation coefficient values (A coeff ). The μ-map CTAC were then segmented into four tissue classes (μ-map 4-classes ), namely background (air), lung, fat, and soft tissue, where a predefined A coeff was assigned to each class. To assess the impact of bone for AC, the bones in the μ-map CTAC were then assigned a predefined soft tissue A coeff (0.1 cm −1 ) to produce an AC μ-map without bones (μ-map no-bones ). Thereafter, both WB static SUV and dynamic PET images were reconstructed using μ-map CTAC , μ-map 4-classes , and μ-map no-bones (PET CTAC, PET 4-classes , and PET no-bones ), respectively. WB indirect and direct parametric K i images were generated using Patlak graphical analysis. Malignant lesions were delineated on PET images with an automatic segmentation method that uses an active contour model (MASAC). Then, the quantitative metrics of the metabolically active tumor volume (MATV), target-to-background (TBR), contrast-to-noise ratio (CNR), peak region-of-interest (ROI peak ), maximum region-of-interest (ROI max ), mean region-of-interest (ROI mean ), and metabolic volume product (MVP) were analyzed. The Wilcoxon test was conducted to assess the difference between PET 4-classes and PET no-bones against PET CTAC for all images. The same test was also adopted to compare the differences between SUV, indirect K i , and direct K i images for each evaluated AC method.Results: No significant differences in MATV, TBR, and CNR were observed between PET 4classes and PET CTAC for either SUV or K i images. PET 4-classes significantly overestimated ROI peak , ROI max , ROI mean , as well as MVP scores compared with PET CTAC in both SUV and K i images. SUV images exhibited the highest median relative errors for PET 4-classes with respect to PET CTAC (RE 4-classes ): 6.91 %, 6.55 %, 5.90 %, and 6.56 % for ROI peak , ROI max , ROI mean , and MVP, respectively. On the contrary, K i images showed slightly reduced RE 4-classes (indirect 5.52 %, 5.95 %, 4.43 %, and 5.70 %, direct 6.61 %, 6.33 %, 5.53 %, and 4.96 %) for ROI peak , ROI max , ROI mean , and MVP, respectively. A higher TBR was observed on indirect and direct K i images relative to SUV, while direct K i images demonstrated the highest CNR. Conclusions: Four-tissue class AC may impact SUV and K i parameter estimation but only to a limited extent, thereby suggesting that WB Patlak K i imaging for dynamic WB PET/MRI studies is feasible. Patlak K i imaging can enhance TBR, thereby facilitating lesion segmentation and quantification. However, patient-specific A coeff for each tissue class should be used when possible to address the high inter...

show abstract

PET/MRI with diagnostic MR sequences vs PET/CT in the detection of abdominal and pelvic cancer

Cited by 27 publications

References 33 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

Systematic review on the accuracy of positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging in the management of ovarian cancer: Is functional information really needed?

Impact of Tissue Classification in MRI-Guided Attenuation Correction on Whole-Body Patlak PET/MRI

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