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

Pace, Leonardo; Nicolai, Emanuele; Aiello, Marco; Catalano, Onofrio A.; Salvatore, Marco

doi:10.1007/s40336-013-0012-4

Cited by 43 publications

(28 citation statements)

References 97 publications

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“…When it comes to hepatocellular carcinoma (HCC), so far there has been no data published regarding PET/MR imaging in the assessment of tumor size; however, it seems that the combination of PET and MR images, especially fMR -functional MR -will make it possible to achieve images better than with PET/CT scans [7]. In primary bone tumors and soft tissue sarcomas the MR scan is the method of choice for staging.…”

Section: Reviewmentioning

confidence: 99%

“…In recent years, clinical studies have shown that diffusion-weighted MR imaging (DWI) may be useful in the assessment of treatment response as well [50][51][52][53]. In this context, PET/MR scans, especially involving functional MR, can improve treatment result evaluation, as well as detection of early relapse [7]. The first prospective research examining the value of PET/MR in evaluating the response to treatment in head and neck tumors has shown excellent results combining a high negative prediction value of PET scans with the high sensitivity of MR scans [54].…”

Section: Reviewmentioning

confidence: 99%

“…On the other hand, MR has several disadvantages: -significantly longer scan time compared with CT; -contraindications in patients with various metal implants, pacemakers and foreign bodies; -significantly higher cost compared with CT [7].…”

Section: Introductionmentioning

confidence: 99%

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PET/MR — a rapidly growing technique of imaging in oncology and neurology

Sałyga

Guzikowska-Ruszkowska²,

Czepczyński

et al. 2016

Nucl. Med. Rev.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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PET/MR — a rapidly growing technique of imaging in oncology and neurology

Sałyga

Guzikowska-Ruszkowska²,

Czepczyński

et al. 2016

Nucl. Med. Rev.

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“…Recently, PET/MR hybrid imaging was introduced as a promising tool in oncological imaging research [3]. One of the potential benefits of PET/MR compared with other imaging modalities may be improved detection and characterization of bone metastases.…”

Section: Introductionmentioning

confidence: 99%

18F-FDG-PET/MR increases diagnostic confidence in detection of bone metastases compared with 18F-FDG-PET/CT

Samarin

Hüllner

Queiroz

et al. 2015

Nuclear Medicine Communications

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PURPOSE: The aim of this study was to compare detection, lesion conspicuity and reader confidence of F-fluorodeoxyglucose (F-FDG)-PET/MR and F-FDG-PET/computed tomography (CT) in patients with F-FDG avid bone metastases. MATERIALS AND METHODS: In this prospective study, a total of 30 PET/CT and PET/MRI data sets were performed in 24 patients. Each examination was evaluated for the presence of PET-positive bone lesions consistent with metastatic involvement. Conspicuity of PET-positive bone lesions was evaluated on the corresponding PET/CT and PET/MR images and compared using the Wilcoxon signed-ranks test. Reader confidence was determined to evaluate whether PET/CT or PET/MR was more useful for the assessment of the bone metastases and was compared using Student's t-test. RESULTS: Overall, in both examinations, PET/CT and PET/MRI detected 86 F-FDG-positive bone lesions. On all 30 PET/MRI examinations, at least one morphological correlate for F-FDG-positive bone lesions was found on the MR component (82 out of 86 lesions). PET/CT imaging allowed identification of corresponding structural changes on the CT component in 23 out of 30 studies (65 out of 86 lesions). In lesion-by-lesion analysis, the mean lesion conspicuity was significantly better on T1 fat MR imaging compared with CT imaging (P=0.005). In seven out of 30 studies, a significant increase in reader confidence of PET/MRI compared with PET/CT was found. CONCLUSION: PET/MRI offers higher reader confidence and improved conspicuity in bone metastases compared with PET/CT. However, the overall detection rate was not different. The highest possible clinical impact of PET/MRI appears to be in patients with limited, early bone metastatic disease. Materials and methods In this prospective study, a total of 30 PET/CT and PET/MRI data sets were performed in 24 patients. Each examination was evaluated for the presence of PET-positive bone lesions consistent with metastatic involvement. Conspicuity of PET-positive bone lesions was evaluated on the corresponding PET/CT and PET/MR images and compared using the Wilcoxon signed-ranks test. Reader confidence was determined to evaluate whether PET/CT or PET/MR was more useful for the assessment of the bone metastases and was compared using Student's t-test. In lesion-by-lesion analysis, the mean lesion conspicuity was significantly better on T1 fat MR imaging compared with CT imaging (P = 0.005). In seven out of 30 studies, a significant increase in reader confidence of PET/MRI compared with PET/CT was found.Conclusion PET/MRI offers higher reader confidence and improved conspicuity in bone metastases compared with PET/CT. However, the overall detection rate was not different. The highest possible clinical impact of PET/MRI appears to be in patients with limited, early bone metastatic disease. Nucl Med Commun 00:000-000

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“…Although the incidence of prostate cancer in focal prostate uptake does not exceed 10 %, and invasive procedures are not justified on the sole basis of metabolic findings, the possible presence of high-grade prostatic carcinoma should be considered. Furthermore, with the progressively wide availability of other relatively more specific tracers for prostate cancer restaging and follow-up (choline and PMSA) [5], FDG-PET/CT in this setting is not recommended, while PET/MRI, seems promising [6].…”

mentioning

confidence: 99%

Time to reconsider FDG-PET/CT for local and distant staging of urological malignancies

Tagliabue

Malaspina

2016

Clin Transl Imaging

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FDG-PET has been a cornerstone in the work-up of many cancers since the 1980s, and the introduction of PET/CT, a valuable technique that makes it possible to add morphological details to metabolic findings, greatly increased the global accuracy of FDG-PET.However, for many years FDG-PET/CT was not considered particularly useful in the management of urological cancers and deemed ''unsuitable'' for the clinical needs of urologists. This view was based on its low sensitivity and specificity in this setting, attributable primarily to the intrinsic low uptake of FDG by cancers arising from the transitional epithelium of the bladder and ureters and from the cells of the kidneys and prostate, but also to the physiological urinary elimination of FDG.Nevertheless, thanks to the fusion of PET and CT images and to increasing understanding of the metabolic behavior of these cancers this view is now being challenged [1].In this setting, the results of both functional and morphological images, provided these derive from carefully standardized procedures (mainly with regard to the amount of FDG injected, the acquisition time, the use of diuretics, and the scan delay time), seem to be quite interesting, and in many conditions close to those obtained by FDG-PET/ CT in other organs and systems. Moreover, FDG-PET/CT is superior to CT in identifying more aggressive cancers (mainly within the prostate) that warrant closer diagnostic attention and more aggressive therapies.It has been reported that renal cell carcinoma (RCC) can actively take up FDG, and this mainly occurs at high grades of malignancy. Unfortunately, the physiological concentration of FDG in the renal pelvis and calices makes it difficult to distinguish between uptake in cancer tissue and in the urinary tract; furthermore, as RCC can also show low or moderately low uptake of FDG, FDG-PET/CT is not currently used in this cancer. However, particular attention should be devoted to the evaluation of incidentally observed renal solid masses with low uptake or no uptake of FDG, as compared to the surrounding background, in order to identify patients requiring referral for further evaluations, using alternative and more accurate procedures. FDG-PET/CT seems to perform better in local lymph node staging and restaging when compared to standard procedures (ceCT and MRI), especially in cases of suspected distant spread. Moreover, in the era of molecular-targeted therapies, FDG uptake can play a role in predicting overall survival in RCC and is an excellent tool for the evaluation of responses to therapy with new drugs, such as tyrosine-kinase inhibitors [2]; the RCC response to tyrosine kinase inhibitors, evaluated using FDG-PET/CT to measure tumor size and FDG uptake after 1 month, can predict progression free survival and overall survival.The use of FDG-PET/CT in the diagnosis of upper tract urinary carcinomas (UTUC) has grown slowly compared to its use in other cancer types, although the emergence of PET/ CT as a standard procedure has boosted its role in this setting. FDG-P...

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

Cited by 43 publications

References 97 publications

PET/MR — a rapidly growing technique of imaging in oncology and neurology

PET/MR — a rapidly growing technique of imaging in oncology and neurology

18F-FDG-PET/MR increases diagnostic confidence in detection of bone metastases compared with 18F-FDG-PET/CT

Time to reconsider FDG-PET/CT for local and distant staging of urological malignancies

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