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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-04-2018 | Original Article

Comparison of ¹⁸F–FDG PET/MRI and MRI alone for whole-body staging and potential impact on therapeutic management of women with suspected recurrent pelvic cancer: a follow-up study

Authors: Lino M. Sawicki, Julian Kirchner, Johannes Grueneisen, Verena Ruhlmann, Bahriye Aktas, Benedikt M. Schaarschmidt, Michael Forsting, Ken Herrmann, Gerald Antoch, Lale Umutlu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2018

Abstract

Purpose

To evaluate the diagnostic performance of ¹⁸F–FDG PET/MRI for whole-body staging and potential changes in therapeutic management of women with suspected recurrent pelvic cancer in comparison with MRI alone.

Methods

Seventy-one consecutive women (54 ± 13 years, range: 25–80 years) with suspected recurrence of cervical (32), ovarian (26), endometrial (7), vulvar (4), and vaginal (2) cancer underwent PET/MRI including a diagnostic contrast-enhanced MRI protocol. PET/MRI and MRI datasets were separately evaluated regarding lesion count, localization, categorization (benign/malignant), and diagnostic confidence (3-point scale; 1–3) by two physicians. The reference standard was based on histopathology results and follow-up imaging. Diagnostic accuracy and proportions of malignant and benign lesions rated correctly were retrospectively compared using McNemar’s chi² test. Differences in diagnostic confidence were assessed by Wilcoxon test.

Results

Fifty-five patients showed cancer recurrence. PET/MRI correctly identified more patients with cancer recurrence than MRI alone (100% vs. 83.6%, p < 0.01). In contrast to PET/MRI, MRI alone missed 4/15 patients with pelvic recurrence and miscategorized 8/40 patients with distant metastases as having local recurrence only. Based on the reference standard, 241 lesions were detected in the study cohort (181 malignant, 60 benign). While PET/MRI provided correct identification of 181/181 (100%) malignant lesions, MRI alone correctly identified 135/181 (74.6%) malignant lesions, which was significantly less compared to PET/MRI (p < 0.001). PET/MRI offered superior diagnostic accuracy (99.2% vs. 79.3%, p < 0.001) and diagnostic confidence in the categorization of malignant lesions compared with MRI alone (2.7 ± 0.5 vs. 2.4 ± 0.7, p < 0.001).

Conclusion

PET/MRI demonstrates excellent diagnostic performance and outperforms MRI alone for whole-body staging of women with suspected recurrent pelvic cancer, indicating potential changes in therapy management based on evaluation of local recurrence and distant metastatic spread.

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Title: Comparison of 18F–FDG PET/MRI and MRI alone for whole-body staging and potential impact on therapeutic management of women with suspected recurrent pelvic cancer: a follow-up study
Authors: Lino M. Sawicki
Julian Kirchner
Johannes Grueneisen
Verena Ruhlmann
Bahriye Aktas
Benedikt M. Schaarschmidt
Michael Forsting
Ken Herrmann
Gerald Antoch
Lale Umutlu
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-017-3881-3

Keynote webinar | Spotlight on medication adherence

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Comparison of ¹⁸F–FDG PET/MRI and MRI alone for whole-body staging and potential impact on therapeutic management of women with suspected recurrent pelvic cancer: a follow-up study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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