<b>Pediatric and Adolescent Lymphoma:</b>Comparison of Whole-Body STIR Half-Fourier RARE MR Imaging with an Enhanced PET/CT Reference for Initial Staging<sup />

Punwani, Shonit; Taylor, Stuart A.; Bainbridge, Alan; Prakash, Vineet; Bandula, Steven; Vita, Enrico De; Olsen, Øystein E.; Hain, Sharon F.; Stevens, Nicola; Daw, Stephen; Shankar, Ananth; Bomanji, Jamshed; Humphries, Paul

doi:10.1148/radiol.09091105

Cited by 124 publications

(103 citation statements)

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“…The results of several studies have shown that whole-body MR imaging allows for more accurate detection of skeletal and extraskeletal metastases in children than does conventional oncologic imaging (16)(17)(18)(19)(20)(21)(22)27,28). These studies were limited by inclusion of patients from a single site, small sample sizes, inclusion of patients with prior treatment, and nonuniformity of the experimental or reference standard imaging.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, although there was an a priori belief among the nodules, but smaller lesions (, 10 mm in diameter) may go undetected (15,29). Similarly, prior reports in patients with lymphoma have shown that sensitivity with whole-body MR imaging is 92%-100% for detecting nodes between 10 and 12 mm in diameter, versus a sensitivity of 67% for nodes between 6 and 12 mm in diameter and 11% for nodes between 1 and 6 mm in diameter (28,30).…”

Section: Pediatric Imaging: Whole-body Mr Imaging For Staging Of Pedimentioning

confidence: 97%

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Whole-Body MR Imaging for Staging of Malignant Tumors in Pediatric Patients: Results of the American College of Radiology Imaging Network 6660 Trial

et al. 2013

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Purpose:To compare whole-body magnetic resonance (MR) imaging with conventional imaging for detection of distant metastases in pediatric patients with common malignant tumors. Materials and Methods:This institutional review board-approved, HIPAA-compliant, multicenter prospective cohort study included 188 patients (109 male, 79 female; mean age, 10.2 years; range, , 1 to 21 years) with newly diagnosed lymphoma, neuroblastoma, or soft-tissue sarcoma. Informed consent was obtained and all patients underwent noncontrast material-enhanced whole-body MR imaging and standardpractice conventional imaging. All images were reviewed centrally by 10 pairs of readers. An independent panel verified the presence or absence of distant metastases. Detection of metastasis with whole-body MR and conventional imaging was quantified by using the area under the receiver operating characteristic curve (AUC). The effects of tumor subtype, patient age, and distant skeletal and pulmonary disease on diagnostic accuracy were also analyzed. Results:Of the 134 eligible patients, 66 (33 positive and 33 negative for metastasis) were selected for image review and analysis. Whole-body MR imaging did not meet the noninferiority criterion for accuracy when compared with conventional imaging for detection of metastasis (difference between average AUCs was 20.03 [95% confidence interval: 20.10, 0.04]); however, the average AUC for solid tumors was significantly higher than that for lymphomas (P = .006). More skeletal metastases were detected by using whole-body MR imaging than by using conventional imaging (P = .03), but fewer lung metastases were detected (P , .001). Patient age did not affect accuracy. Conclusion:The noninferior accuracy for diagnosis of distant metastasis in patients with common pediatric tumors was not established for the use of whole-body MR imaging compared with conventional methods. However, improved accuracy was seen with whole-body MR imaging in patients with nonlymphomatous tumors.q RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Section: Discussionmentioning

confidence: 99%

Section: Pediatric Imaging: Whole-body Mr Imaging For Staging Of Pedimentioning

confidence: 97%

Whole-Body MR Imaging for Staging of Malignant Tumors in Pediatric Patients: Results of the American College of Radiology Imaging Network 6660 Trial

et al. 2013

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“…The sensitivities and specificities of 18 F-FDG PET/CT or 18 F-FDG PET for initial staging of malignant lymphomas are 96%-99% and 95%-100%, respectively (Table 1) (11,12,14,33,34). 18 F-FDG PET is more sensitive than CT in detecting nodal and extranodal lesions in HL and NHL, including lesions in the spleen and bone marrow ( Fig.…”

Section: Initial Stagingmentioning

confidence: 99%

Value of¹⁸F-FDG PET and PET/CT for Evaluation of Pediatric Malignancies

et al. 2015

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Learning Objectives: On successful completion of this activity, participants should be able to (1) understand the current status of the role of 18 F-FDG PET and PET/CT for staging and treatment monitoring of pediatric malignancies; (2) discuss the limitations of 18 F-FDG PET and PET/CT for pediatric cancer imaging; and (3) discuss areas of pediatric cancer imaging in which further studies are needed.

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“…Diffusion-weighted whole-body MRI has been proposed as an alternative to FDG PET/CT, showing comparable accuracy [45,46]. However, more recent data suggest a more conservative approach, since overstaging was observed [47].…”

Section: Whole-body Fdg Pet/mrimentioning

confidence: 99%

Whole-body PET/MRI in oncology: current status and clinical applications

Pace

Nicolai

Aiello

et al. 2013

Clin Transl Imaging

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In oncology, diagnostic imaging plays a major role in staging, therapy assessment and in the evaluation of tumor biology. Multimodality imaging, and more specifically positron emission tomography/computed tomography (PET/CT), has matured into an important imaging tool. The recent introduction of the integrated whole-body PET/ magnetic resonance imaging (MRI) represents the addition of a promising methodology in clinical practice. Combining the metabolic data of PET with the anatomical and functional information provided by MRI and fMRI may further improve the diagnostic value of each method alone. Although the literature is still limited, data indicate a potential advantage of PET/MRI over PET/CT in all the indications where MRI is superior to CT, as well as in the evaluation of tumor biology. Integrated PET/MRI might be performed in addition to the existing imaging modality in specific regions. Moreover, integrated PET/MRI is an alternative to PET/CT when a low radiation dose is required, i.e. in children and in repeated imaging. In the rapidly evolving field of diagnostic imaging, the role of a new modality should be accurately evaluated. Further studies are needed to test the diagnostic accuracy of PET/MRI in different oncology indications. Whether PET/MRI will replace PET/CT or be a complementary methodology and whether it represents true diagnostic progress remains to be evaluated, also taking into account economic considerations.

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Pediatric and Adolescent Lymphoma:Comparison of Whole-Body STIR Half-Fourier RARE MR Imaging with an Enhanced PET/CT Reference for Initial Staging

Abstract: Whole-body STIR half-Fourier RARE MR imaging of pediatric and adolescent lymphoma can accurately depict nodal and extranodal disease and may provide an alternative nonionizing imaging method for anatomic disease assessment at initial staging.

Cited by 124 publications

References 25 publications

Whole-Body MR Imaging for Staging of Malignant Tumors in Pediatric Patients: Results of the American College of Radiology Imaging Network 6660 Trial

Whole-Body MR Imaging for Staging of Malignant Tumors in Pediatric Patients: Results of the American College of Radiology Imaging Network 6660 Trial

Value of¹⁸F-FDG PET and PET/CT for Evaluation of Pediatric Malignancies

Whole-body PET/MRI in oncology: current status and clinical applications

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Pediatric and Adolescent Lymphoma:Comparison of Whole-Body STIR Half-Fourier RARE MR Imaging with an Enhanced PET/CT Reference for Initial Staging

Abstract: Whole-body STIR half-Fourier RARE MR imaging of pediatric and adolescent lymphoma can accurately depict nodal and extranodal disease and may provide an alternative nonionizing imaging method for anatomic disease assessment at initial staging.

Cited by 124 publications

References 25 publications

Whole-Body MR Imaging for Staging of Malignant Tumors in Pediatric Patients: Results of the American College of Radiology Imaging Network 6660 Trial

Whole-Body MR Imaging for Staging of Malignant Tumors in Pediatric Patients: Results of the American College of Radiology Imaging Network 6660 Trial

Value of18F-FDG PET and PET/CT for Evaluation of Pediatric Malignancies

Whole-body PET/MRI in oncology: current status and clinical applications

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Value of¹⁸F-FDG PET and PET/CT for Evaluation of Pediatric Malignancies