A Comparison of ¹⁸F-FDG-PET/MRI and ¹⁸F-FDG-PET/CT in the Cancer Staging of Locoregional Lymph Nodes

Abstract

Aim: The aim of the study was to evaluate the yields of 2-deoxy-2-[ 18 F]-fluoro-D-glucose positronemission tomography/magnetic resonance imaging (18 F-FDG-PET/MRI) and 18 F-FDG-PET/computed tomography (CT) for the detection of metastatic involvement of locoregional neck nodes in patients with head and neck malignancy. Patients and Methods: A total of 90 patients (66 men and 24 women) met the inclusion criteria. Preoperative staging was performed: 53 examinations using PET/CT and 37 using PET/MRI. Results: For PET/MRI, the study demonstrated a sensitivity of 89%, specificity of 64%, positive predictive value of 85%, and negative predictive value of 70%; PET/CT had a sensitivity of 95%, specificity 47%, positive predictive value of 82%, and negative predictive value of 78%. Conclusion: Both methods have a high yield in N-clinical staging with statistically insignificant differences. We assume PET/MRI to be the first-choice method in organ-targeted examinations, for pediatric patients and repeat examinations. In cases of MRI contraindication, PET/CT can be used with no impact on the quality of care.

PET/MR versus PET/CT for locoregional staging of oropharyngeal squamous cell cancer

“…In the present study, we found statistically significant differences between PET/CT and PET/MRI in specificity and accuracy in the nodal staging of HNC for one of two observers. The difference was in favor of PET/MRI, and these findings differ from previous studies that have failed to demonstrate any difference between the methods (5,6,9,17,19,31–33). Most previous studies, however, experienced small samples or used observer consensus as the gold standard.…”

“…In our material, the false-negative findings were scarce whereas the false-positive fraction was significant (Table 1). The sensitivity was higher and the specificity was slightly lower compared to early studies for both PET/ CT and PET/MRI (5,11,34) but were comparable to more recent studies (17,19). This is in line with the tradition at our institute where high sensitivity is favored over specificity since the results from PET imaging are routinely validated by US-FNAC.…”

“…Until recently, only a few studies had investigated the value of FDG-PET/magnetic resonance imaging (FDG-PET/MRI) in the staging of HNC, with equivocal results (5)(6)(7)(8)(9)(10)(11)(12). In recent years, several new studies have highlighted the potential of PET/MRI as an alternative to PET/CT (13)(14)(15)(16)(17)(18)(19)(20). The scientific evidence, however, remains weak.…”

MRI reliability in pediatric abdominal lymph node metastases?

“…In studies comparing PET-CT and PET-MRI, it has been stated that PET-MRI gives better anatomical details in soft tissue and is effective in reducing radiation dose, especially in pediatric patients and patients who need repeated imaging (9). However, PET-MRI has disadvantages due to its high capital cost, limited accessibility, and high exposure times of up to 60 min (10).…”