Abstract
Objective
To demonstrate that positron emission tomography (PET)/magnetic resonance imaging (MRI) fusion was feasible in characterizing pancreatic tumors (PTs), comparing MRI and computed tomography (CT) as mapping images for fusion with PET as well as fused PET/MRI and PET/CT.
Methods
We retrospectively reviewed 47 sets of 18F-fluorodeoxyglucose (18F -FDG) PET/CT and MRI examinations to evaluate suspected or known pancreatic cancer. To assess the ability of mapping images for fusion with PET, CT (of PET/CT), T1- and T2-weighted (w) MR images (all non-contrast) were graded regarding the visibility of PT (5-point confidence scale). Fused PET/CT, PET/T1-w or T2-w MR images of the upper abdomen were evaluated to determine whether mapping images provided additional diagnostic information to PET alone (3-point scale). The overall quality of PET/CT or PET/MRI sets in diagnosis was also assessed (3-point scale). These PET/MRI-related scores were compared to PET/CT-related scores and the accuracy in characterizing PTs was compared.
Results
Forty-three PTs were visualized on CT or MRI, including 30 with abnormal FDG uptake and 13 without. The confidence score for the visibility of PT was significantly higher on T1-w MRI than CT. The scores for additional diagnostic information to PET and overall quality of each image set in diagnosis were significantly higher on the PET/T1-w MRI set than the PET/CT set. The diagnostic accuracy was higher on PET/T1-w or PET/T2-w MRI (93.0 and 90.7%, respectively) than PET/CT (88.4%), but statistical significance was not obtained.
Conclusion
PET/MRI fusion, especially PET with T1-w MRI, was demonstrated to be superior to PET/CT in characterizing PTs, offering better mapping and fusion image quality.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Townsend DW (2008) Dual-modality imaging: combining anatomy and function. J Nucl Med 49:938–955
von Schulthess GK, Steinert HC, Hany TF (2006) Integrated PET/CT: current applications and future directions. Radiology 238:405–422
Soyka JD, Veit-Haibach P, Strobel K et al (2008) Staging pathways in recurrent colorectal carcinoma: is contrast-enhanced 18F-FDG PET/CT the diagnostic tool of choice? J Nucl Med 49:354–361
Antoch G, Freudenberg LS, Beyer T et al (2004) To enhance or not to enhance? 18F-FDG and CT contrast agents in dual-modality 18F-FDG PET/CT. J Nucl Med 45(Suppl 1):56S–65S
Pfannenberg AC, Aschoff P, Brechtel K et al (2007) Low dose non-enhanced CT versus standard dose contrast-enhanced CT in combined PET/CT protocols for staging and therapy planning in non-small cell lung cancer. Eur J Nucl Med Mol Imaging 34:36–44
Tateishi U, Maeda T, Morimoto T et al (2007) Non-enhanced CT versus contrast-enhanced CT in integrated PET/CT studies for nodal staging of rectal cancer. Eur J Nucl Med Mol Imaging 34:1627–1634
Kitajima K, Murakami K, Yamasaki E et al (2008) Performance of integrated FDG-PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG-PET/non-contrast-enhanced CT and enhanced CT. Eur J Nucl Med Mol Imaging 35:1439–1448
Strobel K, Heinrich S, Bhure U et al (2008) Contrast-enhanced 18F-FDG PET/CT: 1-stop-shop imaging for assessing the resectability of pancreatic cancer. J Nucl Med 49:1408–1413
Yamamoto S, Imaizumi M, Kanai Y et al (2010) Design and performance from an integrated PET/MRI system for small animals. Ann Nucl Med 24: 89-98
Judenhofer MS, Catana C, Swann BK et al (2007) PET/MR images acquired with a compact MR-compatible PET detector in a 7-T magnet. Radiology 244:807–814
Judenhofer MS, Wehrl HF, Newport DF et al (2008) Simultaneous PET-MRI: a new approach for functional and morphological imaging. Nat Med 14:459–465
Chang KJ, Kamel IR, Macura KJ et al (2008) 3.0-T MR imaging of the abdomen: comparison with 1.5 T. Radiographics 28:1983–1998
Matos C, Cappeliez O, Winant C et al (2002) MR imaging of the pancreas: a pictorial tour. Radiographics 22:e2
Hussain SM, Zondervan PE, JN IJ et al (2002) Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation. Radiographics 22:1023–1036 (discussion 1037–1029)
Keogan MT, Edelman RR (2001) Technologic advances in abdominal MR imaging. Radiology 220:310–320
Gabata T, Matsui O, Kadoya M et al (1994) Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology 193:683–688
Somer EJ, Marsden PK, Benatar NA et al (2003) PET-MR image fusion in soft tissue sarcoma: accuracy, reliability and practicality of interactive point-based and automated mutual information techniques. Eur J Nucl Med Mol Imaging 30:54–62
Ruf J, Lopez Hanninen E, Bohmig M et al (2006) Impact of FDG-PET/MRI image fusion on the detection of pancreatic cancer. Pancreatology 6:512–519
Seemann MD, Meisetschlaeger G, Gaa J et al (2006) Assessment of the extent of metastases of gastrointestinal carcinoid tumors using whole-body PET, CT, MRI, PET/CT and PET/MRI. Eur J Med Res 11:58–65
Moy L, Ponzo F, Noz ME et al (2007) Improving specificity of breast MRI using prone PET and fused MRI and PET 3D volume datasets. J Nucl Med 48:528–537
Nakamoto Y, Tamai K, Saga T et al (2009) Clinical value of image fusion from MR and PET in patients with head and neck cancer. Mol Imaging Biol 11:46–53
Vellet AD, Romano W, Bach DB et al (1992) Adenocarcinoma of the pancreatic ducts: comparative evaluation with CT and MR imaging at 1.5 T. Radiology 183:87–95
Acknowledgments
This work was supported by Grant-in-Aid for Young Scientists (B) (No.19790874) in Japan.
Conflict of interest
No authors has any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Tatsumi, M., Isohashi, K., Onishi, H. et al. 18F-FDG PET/MRI fusion in characterizing pancreatic tumors: comparison to PET/CT. Int J Clin Oncol 16, 408–415 (2011). https://doi.org/10.1007/s10147-011-0202-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-011-0202-x