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Published in: European Journal of Nuclear Medicine and Molecular Imaging 1/2015

01-01-2015 | Original Article

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

Authors: Karsten Beiderwellen, Johannes Grueneisen, Verena Ruhlmann, Paul Buderath, Bahriye Aktas, Philipp Heusch, Oliver Kraff, Michael Forsting, Thomas C. Lauenstein, Lale Umutlu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2015

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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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Metadata
Title
[18F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results
Authors
Karsten Beiderwellen
Johannes Grueneisen
Verena Ruhlmann
Paul Buderath
Bahriye Aktas
Philipp Heusch
Oliver Kraff
Michael Forsting
Thomas C. Lauenstein
Lale Umutlu
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-014-2902-8

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