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[18F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results

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Abstract

Purpose

To evaluate the diagnostic potential of PET/MRI with [18F]FDG in recurrent ovarian and cervical cancer in comparison to PET/CT.

Methods

A group of 19 patients with suspected recurrence of pelvic malignancies (ovarian cancer, 11 patients; cervical cancer, 8 patients) scheduled for an [18F]FDG PET/CT were subsequently enrolled for a PET/MRI. The scan protocol comprised: (1) a T1-W axial VIBE after contrast agent adminstration, (2) an axial T2-W HASTE, (3) a coronal TIRM, (4) an axial DWI, and dedicated MR sequences of the female pelvis including (5) a T1-W VIBE before contrast agent adminstration, (6) a sagittal T2-W TSE, and (7) a sagittal T1-W dynamic VIBE. The datasets (PET/CT, PET/MRI) were rated separately by two readers regarding lesion count, lesion localization, lesion conspicuity (four-point scale), lesion characterization (benign/malignant/indeterminate) and diagnostic confidence (three-point scale). All available data (histology, prior examinations, PET/CT, PET/MRI, follow-up examinations) served as standard of reference. Median values were compared using the Wilcoxon rank sum test.

Results

Metastatic lesions were present in 16 of the 19 patients. A total of 78 lesions (malignant, 58; benign, 20) were described. Both PET/CT and PET/MRI allowed correct identification of all malignant lesions and provided equivalent conspicuity (3.86 ± 0.35 for PET/CT, 3.91 ± 0.28 for PET/MRI; p > 0.05). Diagnostic confidence was significantly higher for PET/MRI in malignant (p < 0.01) and benign lesions (p < 0.05).

Conclusion

Both PET/CT and PET/MRI offer an equivalently high diagnostic value for recurrent pelvic malignancies. PET/MRI offers higher diagnostic confidence in the discrimination of benign and malignant lesions. Considering the reduced radiation dose and superior lesion discrimination, PET/MRI may serve as a powerful alternative to PET/CT in the future.

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Integrity of research and reporting

All human studies were approved by the local institutional review board and were therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Acknowledgments

This research project was supported by a grant from the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG). LaleUmutlu is a consultant for Bayer HealthCare. The other authors declare no conflicts of interest

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany

    Karsten Beiderwellen, Johannes Grueneisen, Michael Forsting, Thomas C. Lauenstein & Lale Umutlu

  2. Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany

    Verena Ruhlmann

  3. Clinic for Obstetrics and Gynecology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany

    Paul Buderath & Bahriye Aktas

  4. Department of Diagnostic and Interventional Radiology, University of Dusseldorf, 40225, Dusseldorf, Germany

    Philipp Heusch

  5. Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, 45141, Essen, Germany

    Oliver Kraff

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  1. Karsten Beiderwellen
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  2. Johannes Grueneisen
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  10. Lale Umutlu
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Correspondence to Karsten Beiderwellen.

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Beiderwellen, K., Grueneisen, J., Ruhlmann, V. et al. [18F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results. Eur J Nucl Med Mol Imaging 42, 56–65 (2015). https://doi.org/10.1007/s00259-014-2902-8

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  • DOI: https://doi.org/10.1007/s00259-014-2902-8

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