Hybrid [18F]-FDG PET/MRI including non-Gaussian diffusion-weighted imaging (DWI): Preliminary results in non-small cell lung cancer (NSCLC)

Heusch, Philipp; Köhler, Jens; Wittsack, HJ; Heusner, Till A.; Buchbender, Christian; Poeppel, Thorsten D.; Nensa, Felix; Wetter, Axel; Gauler, Thomas; Hartung, Verena; Lanzman, Rotem S.

doi:10.1016/j.ejrad.2013.05.027

Cited by 31 publications

(21 citation statements)

References 29 publications

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“…Recent advances in anticancer treatments have involved different aspects of tumor biology, including tumor cell proliferation and invasion, angiogenesis, and metastasis, all of which can be monitored using FDG‐PET . The pilot results of the present study encourage the use of DCE‐MRI and FDG‐PET in monitoring tumor response to anticancer treatments at different levels.…”

Section: Discussionmentioning

confidence: 56%

Response assessment of stereotactic body radiation therapy using dynamic contrast‐enhanced integrated MR‐PET in non‐small cell lung cancer patients

Huang

Chen

Hsu

et al. 2017

Magnetic Resonance Imaging

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Purpose: To evaluate the response in patients undergoing SBRT using dynamic contrast-enhanced (DCE) integrated magnetic resonance positron emission tomography (MR-PET). Stereotactic body radiation therapy (SBRT) is efficacious as a front-line local treatment for non-small cell lung cancer (NSCLC). Materials and Methods: We prospectively enrolled 19 lung tumors in 17 nonmetastatic NSCLC patients who were receiving SBRT as a primary treatment. They underwent DCE-integrated 3T MR-PET before and 6 weeks after SBRT. The following image parameters were analyzed: tumor size, standardized uptake value (SUV), apparent diffusion coefficient, K trans , k ep , v e , v p , and iAUC 60 . Chest computed tomography (CT) was performed at 3 months after SBRT. Results: SBRT treatment led to tumor changes including significant decreases in the SUV max (-61%, P < 0.001), K trans mean (-72%, P 5 0.005), K trans standard deviation (SD; -85%, P 5 0.046), k ep mean (-53%, P 5 0.014), k ep SD (-63%, P 5 0.001), and v p SD (-58%, P 5 0.002). The PET SUV max was correlated with the MR k ep mean (P 5 0.002) and k ep SD (P < 0.001). The percentage reduction in K trans mean (P < 0.001) and k ep mean (P 5 0.034) at 6 weeks post-SBRT were significantly correlated with the percentage reduction in tumor size, as measured using CT at 3 months after SBRT. Univariate analyses revealed a trend toward disease progression when the initial SUV max > 10 (P 5 0.083). Conclusion: In patients with NSCLC who are receiving SBRT, DCE-integrated MR-PET can be used to evaluate the response after SBRT and to predict the local treatment outcome. Level of Evidence: 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;47:191-199. S tereotactic body radiotherapy (SBRT) is a standard treatment option for patients with stage I non-small cell lung cancer (NSCLC), who are not candidates for surgery.1 Nonrandomized, single-institution, and population-based studies have reported that the clinical outcomes of SBRT are comparable with those of primary surgery, with local control rates of over 90%.2 Furthermore, SBRT offers superior outcomes, lower costs, and greater patient convenience than conventional radiation therapy. 3To evaluate treatment response in cases of lung cancer, researchers commonly use the Response Evaluation Criteria View this article online at wileyonlinelibrary.com.

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Section: Discussionmentioning

confidence: 56%

Response assessment of stereotactic body radiation therapy using dynamic contrast‐enhanced integrated MR‐PET in non‐small cell lung cancer patients

Huang

Chen

Hsu

et al. 2017

Magnetic Resonance Imaging

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“…81 With respect to smaller nodules, the performance of PET-MR imaging was worse than PET-CT in a subsequent study by Chandarana and colleagues, 79 for which the sensitivity of PET-MR imaging was 96% for FDG-avid nodules, 70% for all nodules, and 89% for nodules measuring greater than or equal to 5 mm compared with reference standard PET-CT. Only 38% of nodules less than or equal to 4 mm were detected by PET-MR imaging. In a follow-up study at the same institution, Raad and colleagues 82 reported that 97% of nodules missed on PET-MR imaging resolved or remained stable on follow-up, suggestive of benignity.…”

Section: Pet-mr Imaging Lesion Detection In Lung Cancermentioning

confidence: 97%

“…In 2013, Heusch and colleagues 81 reported a statistically significant inverse correlation between FDG PET SUV and ADC values on PET-MR imaging in subjects with NSCLC. In 2015, Schaarschmidt and colleagues 86 also reported a weak inverse correlation.…”

Section: Additional Pet-mr Imaging Applications In Lung Cancer: Multimentioning

confidence: 99%

Clinical PET-MR Imaging in Breast Cancer and Lung Cancer

Rice

Friedman

2016

PET Clinics

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“…Accordingly, in a recent study from Chandarana et al (22) on 32 patients undergoing PET/CT and PET/MRI, a high sensitivity of PET/MRI for FDG-avid lung lesions (95.6%), yet poor results for FDG-negative lesions was reported. However, for the evaluation of primary lung cancer, PET/MRI offers advantages over PET/CT due to its multiparametric nature allowing for the additional integration of DWI (23,24). In this setting, PET/MRI in oncologic imaging might not only serve as alternative to PET/CT, it can be used to cross-validate the existing modalities of PET and functional MRI (i.e., DWI).…”

Section: Oncologymentioning

confidence: 99%

Clinical applications of PET/MRI: current status and future perspectives

Nensa

Beiderwellen²,

Heusch³

et al. 2014

Diagn Interv Radiol

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117

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Fully integrated positron emission tomography (PET)/magnetic resonance imaging (MRI) scanners have been available for a few years. Since then, the number of scanner installations and published studies have been growing. While feasibility of integrated PET/MRI has been demonstrated for many clinical and preclinical imaging applications, now those applications where PET/MRI provides a clear benefit in comparison to the established reference standards need to be identified. The current data show that those particular applications demanding multiparametric imaging capabilities, high soft tissue contrast and/or lower radiation dose seem to benefit from this novel hybrid modality. Promising results have been obtained in whole-body cancer staging in non-small cell lung cancer and multiparametric tumor imaging. Furthermore, integrated PET/MRI appears to have added value in oncologic applications requiring high soft tissue contrast such as assessment of liver metastases of neuroendocrine tumors or prostate cancer imaging. Potential benefit of integrated PET/ MRI has also been demonstrated for cardiac (i.e., myocardial viability, cardiac sarcoidosis) and brain (i.e., glioma grading, Alzheimer's disease) imaging, where MRI is the predominant modality. The lower radiation dose compared to PET/computed tomography will be particularly valuable in the imaging of young patients with potentially curable diseases. However, further clinical studies and technical innovation on scanner hard-and software are needed. Also, agreements on adequate refunding of PET/MRI examinations need to be reached. Finally, the translation of new PET tracers from preclinical evaluation into clinical applications is expected to foster the entire field of hybrid PET imaging, including PET/MRI. B oth positron emission tomography (PET) and magnetic resonance imaging (MRI) are well-established imaging modalities that have been clinically available for more than 30 years. However, the combination of PET and computed tomography (CT) into PET/CT has heralded a new era of hybrid imaging driven by the rapid ascend of PET/CT and the decline of stand-alone PET. The integration of PET and CT into a hybrid system provided added value that exceeds the sum of its parts, in particular fast and accurate attenuation correction and the combination of anatomical and molecular information.Inspired by the vast success of PET/CT, the combination of PET and MRI was an obvious goal. Therefore initial solutions comprised the software based co-registration and post-hoc fusion (1) of independently acquired PET and MRI data, as well as shared tabletop sequential PET and MRI acquisition (2, 3). While the integration of PET and CT into a hybrid system was challenging but technically feasible, the integration of PET and MRI was considered extremely demanding, if not impossible. Two main technical challenges that had to be solved: in the first place development of a PET insert that is compatible to high magnetic field strengths normally used in MRI, and vice versa development ...

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Hybrid [18F]-FDG PET/MRI including non-Gaussian diffusion-weighted imaging (DWI): Preliminary results in non-small cell lung cancer (NSCLC)

Cited by 31 publications

References 29 publications

Response assessment of stereotactic body radiation therapy using dynamic contrast‐enhanced integrated MR‐PET in non‐small cell lung cancer patients

Response assessment of stereotactic body radiation therapy using dynamic contrast‐enhanced integrated MR‐PET in non‐small cell lung cancer patients

Clinical PET-MR Imaging in Breast Cancer and Lung Cancer

Clinical applications of PET/MRI: current status and future perspectives

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