Prospective comparison of the impact on treatment decisions of whole-body magnetic resonance imaging and computed tomography in patients with metastatic malignant melanoma

Müller-Horvat, C.; Radny, P.; Eigentler, Thomas; Schäfer, Jürgen; Pfannenberg, Christina; Horger, Marius; Khorchidi, S; Nägele, Thomas; Garbe, Claus; Claussen, Claus D.; Schlemmer, Heinz Peter

doi:10.1016/j.ejca.2005.10.008

Cited by 95 publications

(48 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Magnetic resonance imaging has proven to be more sensitive and specific in the detection of soft tissue metastases or abdominal metastases (e.g. lymph nodes, liver, adipose tissue, muscle) [303,627].…”

Section: Ct/mrimentioning

confidence: 99%

“…According to comparative studies on the detection of extracerebral metastases in melanoma patients between PET/CT versus whole-body MRI [302] and whole-body MRI versus whole-body CT [303], PET/CT is superior to whole-body MRI und whole-body MRI is superior to whole-body CT. Regarding the practical implementation of cross-sectional imaging, the practical and economic availability of the respective imaging method has to be taken into account.…”

Section: Level Of Evidence 1amentioning

confidence: 99%

See 1 more Smart Citation

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

Self Cite

180

148

View full text Add to dashboard Cite

Section: Ct/mrimentioning

confidence: 99%

Section: Level Of Evidence 1amentioning

confidence: 99%

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

Self Cite

180

148

View full text Add to dashboard Cite

“…Similarly, the recent introduction of truly integrated PET/MR imaging scanners has generated much interest. The superior softtissue contrast of MR imaging, compared with CT, in evaluating lesion infiltration in soft-tissue planes and adjacent organs is a major step forward in the staging of various cancers (7,8), particularly in the brain, head and neck, liver, pelvis, and bone marrow (8,9). Furthermore, the lack of radiation using MR imaging is a major advantage over CT, though this is less significant after the introduction of CT dose modulation software, which has reduced the radiation to 2-5 mSv without any compromise in resolution (10,11).…”

mentioning

confidence: 99%

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

et al. 2013

View full text Add to dashboard Cite

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.

show abstract

“…This requires repeated whole-body assessment of the extent of the disease, relapses, complications, and concomitant diseases. Clinical studies comparing 18 F-FDG PET/CT and whole-body MRI indicate that therapeutically relevant information is frequently obtained by PET or MRI but not necessarily by CT (19)(20)(21)(22)(23). For example, MRI is more sensitive than PET/CT in the detection of brain, bone, and liver metastases, whereas PET/CT is more accurate in the detection of lymph node metastases, characterization soft-tissue masses, and therapy monitoring (Fig.…”

Section: Whole-body Pet/mrimentioning

confidence: 99%

PET/MRI: Paving the Way for the Next Generation of Clinical Multimodality Imaging Applications

Pichler¹,

Kolb²,

Nägele³

et al. 2010

J Nucl Med

Self Cite

390

240

View full text Add to dashboard Cite

Multimodality imaging and, more specifically, the combination of PET and CT has matured into an important diagnostic tool. During the same period, concepts for PET scanners integrated into an MR tomograph have emerged. The excellent soft-tissue contrast of MRI and the multifunctional imaging options it offers, such as spectroscopy, functional MRI, and arterial spin labeling, complement the molecular information of PET. The development of a fully integrated PET/MRI system is technologically challenging. It requires not only significant modifications of the PET detector to make it compact and insensitive to magnetic fields but also a major redesign of the MRI hardware.Key Words: clinical multimodality imaging; PET; CT; PET/CT; arterial spin labeling (ASL); fMRI; spectroscopy; magnetic resonance tomograph (MRT); PET/MRI; positron emission tomography; MR/PET J Nucl Med 2010; 51: 333-336 DOI: 10.2967/jnumed.109.061853 Over the last 20 years, PET and MRI systems have evolved slowly but steadily. The photomultiplier-based PET detectors have remained more or less unchanged, ensuring stable operation and good signal performance despite bulk and high sensitivity to even the smallest magnetic fields. Improvements in PET technology were achieved with faster and low-noise electronics, faster and brighter scintillation crystals, optimized light-sharing schemes for the scintillation crystal arrangements, and smaller crystals (1). These adaptations led to PET scanners with whole-body scan times as short as 10 min, yielding-together with improved reconstructions, attenuation-and scatter-correction algorithms-low-noise PET images. Advances paved the way to implementing the idea of time-of-flight PET in clinical scanners (2). Without a doubt, the most important step toward the establishment of PET as a clinically viable tool was the introduction of combined PET/ CT in 1998 by David Townsend and Ronald Nutt (3-5). Nevertheless, many physicians of that time remained skeptical about the advantages of this dual-modality imaging system over stand-alone PET and CT.Clinical MRI evolved toward higher fields, faster imaging sequences, and whole-body imaging capabilities. Especially for brain imaging, 3-T MRI is now the standard. Novel coil concepts combined with parallel acquisition techniques helped shorten examination times while maintaining high imaging quality (6). PET/MRI: TECHNICAL EVOLUTIONThe idea to combine PET and MRI arose as early as the mid 1990s, even before PET/CT was introduced. Simon Cherry and Paul Marsden saw the need for PET/MRI in small-animal imaging studies to add anatomic landmarks with high softtissue contrast to the molecular information delivered by PET (7). Preclinical PET/MRI work was followed by immediate commercial interest in combining PET and MRI, probably driven by the limited sensitivity of MRI to trace biomarkers or to reveal metabolites.The PET/MRI combination requires 3 risky technologic steps that modify state-of-the-art PET and MRI. First, the photomultiplier technology must be replaced with magn...

show abstract

Prospective comparison of the impact on treatment decisions of whole-body magnetic resonance imaging and computed tomography in patients with metastatic malignant melanoma

Cited by 95 publications

References 13 publications

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

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

PET/MRI: Paving the Way for the Next Generation of Clinical Multimodality Imaging Applications

Contact Info

Product

Resources

About