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PET/MRI for neuroendocrine tumors: a match made in heaven or just another hype?

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Abstract

Purpose

To evaluate the current literature on technical feasibility and diagnostic value of PET/MRI in management of patients with neuroendocrine tumors (NETs).

Methods

A systematic literature search of the PubMed/MEDLINE database identified studies that evaluated the role of simultaneous PET/MRI for the evaluation of neuroendocrine tumors in human subjects. Exclusion criteria included studies lacking simultaneous PET/MRI, absence of other than attenuation-correction MRI pulse sequences, and case reports. No data-pooling or statistical analysis was performed due to the small number of articles and heterogeneity of the methodologies.

Results

From the 21 identified articles, five were included, which demonstrated successful technical feasibility of simultaneous PET/MRI through various imaging protocols in a total of 105 patients. All articles demonstrated equal or superior detection of liver lesions by PET/MRI over PET/CT. While one study reported superior detection of bone lesions by PET/MRI, two demonstrated favorable detection by PET/CT. Two studies demonstrated superiority of PET/CT in detection of nodal metastases; three studies reported the pitfall of PET/MRI in detection of lung lesion.

Conclusion

The current literature reports successful technical feasibility of PET/MRI for imaging of NETs. While whole-body PET/CT in conjunction with an abdominal MRI may serve as a comprehensive approach for baseline staging, follow-up with PET/MRI may be preferred for those with liver-only disease. Another possible role for PET/MRI is to provide a multiparametric approach to follow-up of response to treatment. With further advances in MRI imaging acquisitions and post-processing techniques, PET/MRI may become more applicable to a broader group of patients with NETs, and possibly the imaging modality of choice for this patient population.

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Funding

This research was funded in part through the United States National Institute of Health/National Cancer Institute (NIH/NCI) Cancer Center Support Grant P30 CA008748.

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Authors and Affiliations

  1. Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI, 53792-3252, USA

    Ali Pirasteh

  2. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Ali Pirasteh, Christopher Riedl, Marius Erik Mayerhoefer, Romina Grazia Giancipoli, Steven Mark Larson & Lisa Bodei

  3. Department of Nuclear Medicine, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy

    Romina Grazia Giancipoli

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  1. Ali Pirasteh
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Contributions

AP: literature search and review, manuscript writing and editing, content planning, material collection. CR: literature search and review, manuscript writing and editing. MEM: literature search and review, manuscript writing and editing. RGG: manuscript writing and editing, content planning, material collection. SML: manuscript editing, content planning. LB: literature review, manuscript writing editing, content planning.

Corresponding author

Correspondence to Ali Pirasteh.

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Conflict of interest

Ali Pirasteh: Nothing to disclose. Christopher Riedl: Nothing to disclose. Marius Erik Mayerhoefer: Speaker honoraria from Siemens Healthcare and Bristol-Myers Squibb and research support from Siemens Healthcare. Romina Grazia Giancipoli: Nothing to disclose. Steven Mark Larson: receiving commercial research grants from Genentech, Inc., WILEX AG, Telix Pharmaceuticals Limited, and Regeneron Pharmaceuticals, Inc.; holding ownership interest/equity in Voreyda Theranostics Inc. and Elucida Oncology Inc., and holding stock in ImaginAb, Inc. SML is the inventor and owner of issued patents both currently unlicensed and licensed by MSK to Samus Therapeutics, Inc., Y-mAbs Therapeutics Inc., and Elucida Oncology, Inc. SML is or has served as a consultant to Cynvec LLC, Eli Lilly & Co., Prescient Therapeutics Limited, Advanced Innovative Partners, LLC, Gerson Lehrman Group, Progenics Pharmaceuticals, Inc., and Janssen Pharmaceuticals, Inc. Lisa Bodei: Consultancy and speaker for AAA and Ipsen; consultancy for Curium.

Human rights and animal welfare

This review article does not contain any imaging studies with human or animal subjects performed by the authors solely for the purposes of this review. The provided images are from exams performed for the purposes of clinical care at the authors’ institution (Memorial Sloan Kettering Cancer Center), and not with the prospective intention of being utilized for this review. No Institutional Review Board approval or patient consent was required for the purposes of this literature review. All patient information was handled according the United States Health Insurance and Accountability Act.

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Pirasteh, A., Riedl, C., Mayerhoefer, M.E. et al. PET/MRI for neuroendocrine tumors: a match made in heaven or just another hype?. Clin Transl Imaging 7, 405–413 (2019). https://doi.org/10.1007/s40336-019-00344-1

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