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European Radiology
Published in: European Radiology 2/2017

01-02-2017 | Chest

Thoracic staging with 18F-FDG PET/MR in non-small cell lung cancer – does it change therapeutic decisions in comparison to 18F-FDG PET/CT?

Authors: Benedikt M. Schaarschmidt, Johannes Grueneisen, Martin Metzenmacher, Benedikt Gomez, Thomas Gauler, Christian Roesel, Philipp Heusch, Verena Ruhlmann, Lale Umutlu, Gerald Antoch, Christian Buchbender

Published in: European Radiology | Issue 2/2017

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Abstract

Objective

To investigate whether differences in thoracic tumour staging between 18F-FDG PET/CT and PET/MR imaging lead to different therapeutic decisions in Non-Small Cell Lung Cancer (NSCLC).

Material and methods

Seventy-seven NSCLC patients that underwent whole-body 18F-FDG PET/CT from the base of skull to the upper thighs and thoracic PET/MR were enrolled in this retrospective study. Thoracic PET/CT and PET/MR images were staged according to the 7th edition of the AJCC staging manual. Staging results of both modalities were discussed separately in a simulated interdisciplinary tumour board and therapeutic decisions based on both imaging modalities were recorded. Descriptive statistics were used to compare the results and reasons for changes in the therapeutic decision were investigated.

Results

Staging results differed in 35 % of patients (27 patients) between thoracic PET/CT and PET/MR. Differences were detected when assessing the T-stage in 18 % (n = 14), the N-stage in 23 % (n = 18), and the M-stage in 1 % (n = 1). However, patient therapy management was changed in only six patients (8 %).

Conclusion

Despite the variability of thoracic 18F-FDG PET/CT and PET/MR in TNM-staging, both modalities lead to comparable therapeutic decisions in patients suffering from NSCLC. Hence, 18F-FDG PET/MR can be considered an possible alternative to 18F-FDG PET/CT for clinical NSCLC staging.

Key points

• PET/CT and PET/MR provide comparable results in early stages in NSCLC
• Clinical impact of different staging results has not been investigated
• PET/CT and PET/MR lead to comparable therapeutic decisions
• PET/MR can be considered an alternative to PET/CT for NSCLC staging
Appendix
Available only for authorised users
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Metadata
Title
Thoracic staging with 18F-FDG PET/MR in non-small cell lung cancer – does it change therapeutic decisions in comparison to 18F-FDG PET/CT?
Authors
Benedikt M. Schaarschmidt
Johannes Grueneisen
Martin Metzenmacher
Benedikt Gomez
Thomas Gauler
Christian Roesel
Philipp Heusch
Verena Ruhlmann
Lale Umutlu
Gerald Antoch
Christian Buchbender
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4397-0

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