Diagnostic Value of Delayed PET/MR in Liver Metastasis in Comparison With PET/CT

Zhou, Nina; Meng, Xiangxi; Zhang, Yan; Yu, Boqi; Yuan, Jianmin; Yu, Jiangyuan; Zhu, Hua

doi:10.3389/fonc.2021.717687

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…Given the physiologic [ 18 F]FDG activity in the liver, the quality of PET data is extremely crucial for identi cation of "hot" pathologic spots. The better PET quality of the PET-MRI system that is demonstrated in our data, which proved advantageous in around one-tenth of the current study's cases, was previously described only by Zhou et al [12], who attributed this phenomenon to later image acquisition (time from radiotracer injection). We assume this could also be related to longer PET acquisition time (2.5-3 vs 20 minute per bed position) and hence better spatial resolution, and to other technical parameters (such as 4 vs 5 detector rings), a question that remains to be explored.…”

Section: Discussionsupporting

confidence: 71%

“…In the context of assessing malignant hepatic involvement, previous data support the bene t provided by [ 18 F]FDG PET-CT, MRI, and retrospective fusion of [ 18 F]FDG-PET and MRI [1][2][3][4][5][6][7][8][9]. However, data on the use of integrated PET-MRI systems are still very limited [10][11][12][13].…”

Section: Discussionmentioning

confidence: 96%

“…Assessing the extent of malignant hepatic involvement in oncologic patients, for either staging, restaging or monitoring response to therapy, depends on the applied imaging modality. Not only potentially altering lesion detection rate, the selected imaging modality may affect the interpreting physician's degree of con dence, and hence ease or complicate clinical workup [1][2][3][4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…In the context of assessing malignant hepatic involvement, only few previous studies focused on the role of integrated PET-MRI systems, reporting similar [10] or superior [11][12][13] performance of PET-MRI over PET-CT, mainly highlighting the conspicuity provided by MR imaging.…”

Section: Introductionmentioning

confidence: 99%

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A lesson in humility: the added values of PET-MRI over PET-CT in detecting malignant hepatic lesions

Cohen

Kesler

Kurash

et al. 2023

Eur J Nucl Med Mol Imaging

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Purpose: The recent introduction of integrated PET-MRI systems into practice seems promising in oncologic imaging. Efforts are made to specify the added-values of this modality. The current study evaluates the added-values of PET-MRI over PET-CT in detecting active malignant hepatic lesions.Methods: As part of an ongoing prospective study in our institution that assesses the added-values of PET-MRI over PET-CT, subjects undergo whole-body PET-CT and subsequent dedicated PET-MRI after single radiotracer injection. The current study included 97 consecutive paired [18F]FDG PET-CT and liver PET-MRI scans (of 61 patients) interpreted as showing active malignant hepatic involvement. Primary malignancies were of colorectal/biliary/pancreatic/breast/other origins in 19/9/9/7/17 patients. Eightysix paired scans were performed for monitoring response to therapy. When PET-MRI detected additional malignant lesions over PET-CT, lesions size, the main advantage PET-MRI offered, and the in uence on the nal report were recorded.Results: In 37/97 (38.1%) cases, a total of 78 malignant lesions were reported based on PET-MRI data only. The improved detectability on PET-MRI was evident in three groups of lesions: (1) [18F]FDG-avid lesions seen on PET of PET-MRI but not on PET of PET-CT (11 cases, 19 lesions); (2) small lesions (≤0.8cm) identi ed by MRI only (14 cases, 37 lesions); (3) lesions >0.8cm with low/no [18F]FDG-uptake categorized as viable based on MRI (12 cases, 22 lesions). These lesions caused major effect on nal reports in 11/97 (11.3%) cases, changing reported response assessment category (10/86 cases) or de ning malignant hepatic disease on staging/restaging scans (1/11 cases).Conclusion: PET-MRI offers several advantages over PET-CT in assessing the extent and response to therapy of malignant hepatic involvement. Additional malignant lesions are detected by PET-MRI due to better PET performance, greater spatial resolution provided by MRI, and improved multi-parametric viability assessment of lesions. In around one-tenth of cases, such ndings signi cantly change the nal report's conclusion.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A lesson in humility: the added values of PET-MRI over PET-CT in detecting malignant hepatic lesions

Cohen

Kesler

Kurash

et al. 2023

Eur J Nucl Med Mol Imaging

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“…Because of the diverse presentation of GIST liver metastases on MRI and PET/CT, for some liver lesions with qualitative difficulties, the combination of both imaging methods can evaluate the lesions' metabolism and blood perfusion simultaneously, which may be helpful for diagnosis. PET/MR has become more widely used in recent years and has been proven to be a quite efficient diagnostic modality compared to PET/CT, MR, and CT for the diagnosis of liver metastases ( 31 , 32 ), although these literatures selected liver metastases from other common tumors and it may be equally applicable to GIST liver metastases. There were some limitations in our study.…”

Section: Discussionmentioning

confidence: 99%

18F-FDG PET/CT and MR imaging features of liver metastases in gastrointestinal stromal tumors: a cross-sectional analysis

Lyu¹,

Lin²,

Tang³

et al. 2022

Ann Transl Med

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Background: Early detection of gastrointestinal stromal tumor (GIST) liver metastases is crucial for the management and prognosis. In our experience, GIST liver metastases can display hypermetabolism on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and marked enhancement on magnetic resonance imaging (MRI), which are uncommon in other tumors before treatment. Most literature focus on the imaging evaluation, prognosis after treatment and less is known about imaging features on both imaging methods before treatment. This study analyzes the imaging features of newly diagnosed GIST liver metastases on 18 F-FDG PET/CT and MRI, with goal of improving diagnostic accuracy.Methods: This retrospective study included 55 patients with pathological or radiographical confirmed GIST liver metastases who underwent PET/CT (n=29), MRI (n=22), or both methods (n=4). PET/ CT and MRI interpretation including lesion's morphologic features, number, density or signal intensity, hemorrhage, cystic changes or necrosis, maximum standardized uptake value (SUV max ) of liver metastases and liver background on PET imaging, degree and pattern of enhancement on MRI were obtained by two experienced nuclear medicine physicians and two radiologists respectively. Data are presented as numbers, percentages, means ± standard deviations or median (interquartile range). The correlation between diameter and SUV max of metastases, and primary tumor SUV max and synchronous liver metastases SUV max were analyzed by Spearman's rank test.Results: On PET/CT visual analysis, 38.9%, 23.9%, and 37.2% of lesions showed significant hypermetabolism, slightly higher metabolism, and equal or lower metabolism than liver, respectively. There was a weak correlation between the diameter and SUV max of liver metastases (r s =0.370, P<0.001), and a moderate correlation between SUV max of synchronous liver metastases and the primary tumors (r s =0.492, P<0.001). On contrast-enhanced MRI, 90.8% of lesions showed heterogeneous enhancement in the arterial phase with the variable presentation, and 74.3% had different enhancement patterns between margins and intratumoral parenchyma.Conclusions: Liver lesions in GIST displaying significant, slight hypermetabolism on 18 F-FDG PET/ CT, marked or heterogeneous gradual enhancement within the intratumoral parenchyma with ring-like ^ ORCID: 0000-0003-2770-8909. enhancement on MRI may denote the diagnosis of liver metastasis. However, GIST liver metastases may also display equal or lower metabolism than liver parenchyma on PET, making small lesions more difficult to diagnose.

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Use of 18F‐FDG PET/MRI as an Initial Staging Procedure for Nasopharyngeal Carcinoma

Fang

Qiang

et al. 2023

Magnetic Resonance Imaging

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BackgroundCompared with the conventional work‐up (CWU) including computed tomography (CT) of the chest and abdomen, MRI of the head and neck, and skeletal scintigraphy, positron emission tomography (PET)/MRI might improve diagnostic accuracy, shorten the work‐up time, and reduce false‐positive (FP) findings in patients with nasopharyngeal carcinoma (NPC). However, evidence of cost‐effectiveness is needed for the adoption of PET/MRI for the initial staging in NPC.PurposeTo evaluate the cost‐effectiveness and clinical value of PET/MRI as an initial staging procedure for NPC.Study TypeRetrospective cohort cost effectiveness study.SubjectsThree hundred forty‐three patients with a median age of 51 (13–81) years underwent PET/MRI before treatment (the PET/MRI group) and the remaining 677 patients with a median age of 55 (15–95) years only underwent CWU (the CWU group). There were 80 (23.3%) females and 193 (28.5%) females in the PET/MRI and CWU groups, respectively.Field Strength/Sequence3‐T integrated PET/MRI system, diffusion‐weighted echo‐planar imaging (b = 0 and 1000 s/mm2) and [18F] fluorodeoxyglucose PET.AssessmentThe primary end point was the FP rate. Costs were determined as issued in 2021 by the Medical Insurance Administration Bureau of Zhejiang, China.Statistical TestsIncremental cost effectiveness ratio (ICER) measured cost of using PET/MRI per percent of patients who avoided a FP. A P‐value <0.05 was considered statistically significant.ResultsFor the whole group, the de novo metastatic disease rate was 5.2% (53/1020). A total of 187 patients with FP results were observed. Significantly more patients with FP results were observed in the CWU group compared to the PET/MRI group (25.6% vs. 4.1%). The ICER was $54 for each percent of patients avoiding a FP finding.Data ConclusionCompared with CWU, PET/MRI may reduce the FP risk. Furthermore, PET/MRI may be cost‐effective as an initial staging procedure for NPC.Evidence Level3Technical EfficacyStage 6

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Diagnostic Value of Delayed PET/MR in Liver Metastasis in Comparison With PET/CT

Cited by 11 publications

References 33 publications

A lesson in humility: the added values of PET-MRI over PET-CT in detecting malignant hepatic lesions

A lesson in humility: the added values of PET-MRI over PET-CT in detecting malignant hepatic lesions

18F-FDG PET/CT and MR imaging features of liver metastases in gastrointestinal stromal tumors: a cross-sectional analysis

Use of 18F‐FDG PET/MRI as an Initial Staging Procedure for Nasopharyngeal Carcinoma

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