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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-02-2016 | Original Article

[¹⁸F]FDG PET/CT outperforms [¹⁸F]FDG PET/MRI in differentiated thyroid cancer

Authors: Alexis Vrachimis, Matthias Christian Burg, Christian Wenning, Thomas Allkemper, Matthias Weckesser, Michael Schäfers, Lars Stegger

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2016

Abstract

Purpose

To evaluate the diagnostic potential of PET/MRI with [¹⁸F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated.

Methods

The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [¹⁸F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [¹⁸F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference.

Results

Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [¹⁸F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions.

Conclusion

In patients with thyroid cancer and suspected or known dedifferentiation, [¹⁸F]FDG PET/MRI was inferior to low-dose [¹⁸F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [¹⁸F]FDG PET/MRI was equal to contrast-enhanced neck [¹⁸F]FDG PET/CT. Therefore, [¹⁸F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast agent is contraindicated.

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Title: [18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer
Authors: Alexis Vrachimis
Matthias Christian Burg
Christian Wenning
Thomas Allkemper
Matthias Weckesser
Michael Schäfers
Lars Stegger
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3195-2

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Springer Medicine

[¹⁸F]FDG PET/CT outperforms [¹⁸F]FDG PET/MRI in differentiated thyroid cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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