Three-way Comparison of Whole-Body MR, Coregistered Whole-Body FDG PET/MR, and Integrated Whole-Body FDG PET/CT Imaging: TNM and Stage Assessment Capability for Non–Small Cell Lung Cancer Patients

Ohno, Yoshiharu; Koyama, Hisanobu; Yoshikawa, Takeshi; Takenaka, Daisuke; Seki, Shu; Yui, Masao; Yamagata, Hitoshi; Aoyagi, Kazuhei; Matsumoto, Shinsuke; Sugimura, Kazuro

doi:10.1148/radiol.14140936

Cited by 67 publications

(52 citation statements)

References 31 publications

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“…Several groups have suggested whole-body PET/MR protocols for lung cancer patients, all of which contain at least 1 pulse sequence specifically tailored to the chest, and most of them with exceptionally long MR acquisition times (5-9). Ohno et al showed that coregistered PET and whole-body MR is superior to PET/CT for the staging of lung cancer patients, partly contradicting previous results for whole-body MR only (8,(10)(11)(12). Fraioli et al demonstrated that PET/MR is accurate in the assessment of NSCLC resectability, detecting the correct T stage and N stage in 74% of patients (6).…”

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confidence: 97%

TNM Staging of Non–Small Cell Lung Cancer: Comparison of PET/MR and PET/CT

et al. 2015

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The purpose of this study was to compare the diagnostic accuracy of whole-body unenhanced PET/MR with that of PET/CT in determining the stage of non-small cell lung cancer. Methods: This study was approved by the institutional review board and by national government authorities. Forty-two consecutive patients referred for the initial staging of non-small cell lung cancer underwent whole-body imaging with a sequential trimodality PET/CT/MR system. PET/MR and PET/CT datasets were evaluated separately, and a TNM stage was assigned on the basis of the image analysis. Nodal stations in the chest were identified according to the mapping system of the American Thoracic Society. The standard of reference was histopathology for the tumor stage in 20 subjects, for the nodal stage in 22 patients, and for extrathoracic metastases in 5 subjects. All other lesions were confirmed by at least 1 different imaging method. A Wilcoxon signed-ranks test was used for comparing PET/MR with PET/CT. Results: PET/MR did not provide additional information compared with PET/CT. The diagnostic accuracy of both imaging modalities was equal (T staging, P 5 0.177; N staging, P 5 0.114; M staging, P 5 0.465), however, with advantages for PET/CT by trend. In the subgroup with histopathologic confirmation of T and N stages, the situation was similar (T staging, P 5 0.705; N staging, P 5 0.334). Conclusion: This study indicates that PET/MR using a fast MR protocol does not improve the diagnostic accuracy of the staging of non-small cell lung cancer.

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confidence: 97%

TNM Staging of Non–Small Cell Lung Cancer: Comparison of PET/MR and PET/CT

et al. 2015

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“…Although T staging had no significance with PET/CT, the diagnostic accuracy for N stage of MR imaging including STIR fast advanced spin echo (FASE) imaging, PET/MRI, and PET/CT was 98.6% for MR imaging; 98.6% and 92.1% for PET/MRI with and without signal intensity (SI) assessment based on STIR FASE imaging, respectively; and 92.1% for PET/CT (Ohno et al 2015). In addition, the accuracy of STIR FASE imaging and PET/MRI with SI assessment was significantly higher than that of PET/MRI without SI assessment and of PET/CT (Ohno et al 2015). Moreover, sensitivity of STIR FASE imaging (100%) and PET/MRI with SI assessment (100%) were significantly higher than that of whole-body PET/MRI without SI assessment (93.8%) and of PET/CT (93.8%) (Ohno et al 2015) (Fig.…”

Section: Mr Assessment Of N Classificationmentioning

confidence: 99%

Lung Cancer

Ohno¹,

Koyama²,

Dinkel³

2016

MRI of the Lung

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Since the publication of the Radiologic Diagnostic Oncology Group Report (RDOG) in 1991, the clinical application of pulmonary magnetic resonance (MR) imaging to patients with lung cancer has been limited. MDCT has been much more widely available for staging of lung cancer in clinical situations. Traditionally, FDG-PET or PET/CT is the only modality that reveals biological glucose metabolism of lung cancer, and ventilation and/or perfusion scintigraphy is the only modality that demonstrates pulmonary function. However, recent advances of MR systems and utilization of contrast media make it possible to overcome the limitation of chest MR imaging. Therefore, in the last years, several investigators have demonstrated the significant comprehensive potential of MR imaging to substitute for MDCT and nuclear medicine examinations in lung cancer staging. Currently, MR imaging in lung cancer patients can be applied for (1) detection of pulmonary nodules, (2) characterization of solitary pulmonary nodules, and (3) assessment of TNM classification in routine clinical practice. We believe that further basic studies, as well as clinical applications of newer MR techniques, will play an important role in the future management of patients with lung cancer including MRI.

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“…Fused PET/MRI improved lesion depiction, localization, and quality of diagnosis more than PET/CT in gynecologic malignancy [26]. MR signal intensity assessement on fused PET/MRI improved diagnostic accuracy for pre-operative staging more than PET/CT in lung cancer (97.1 % vs. 85.0 %, respectively) [27].…”

Section: Retrospective Image Fusion Of Pet and Mrimentioning

confidence: 99%

FDG Whole-Body PET/MRI in Oncology: a Systematic Review

Kwon

Becker

Goo

et al. 2016

Nucl Med Mol Imaging

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The recent advance in hybrid imaging techniques enables offering simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI) in various clinical fields. 18F-fluorodeoxyglucose (FDG) PET has been widely used for diagnosis and evaluation of oncologic patients. The growing evidence from research and clinical experiences demonstrated that PET/MRI with FDG can provide comparable or superior diagnostic performance more than conventional radiological imaging such as computed tomography (CT), MRI or PET/CT in various cancers. Combined analysis using structural information and functional/molecular information of tumors can draw additional diagnostic information based on PET/MRI. Further studies including determination of the diagnostic efficacy, optimizing the examination protocol, and analysis of the hybrid imaging results is necessary for extending the FDG PET/MRI application in clinical oncology.

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Three-way Comparison of Whole-Body MR, Coregistered Whole-Body FDG PET/MR, and Integrated Whole-Body FDG PET/CT Imaging: TNM and Stage Assessment Capability for Non–Small Cell Lung Cancer Patients

Abstract: Accuracies of whole-body MR imaging and PET/MR imaging with SI assessment are superior to PET/MR without SI assessment and PET/CT for identification of TNM factor, clinical stage, and operability evaluation of NSCLC patients.

Cited by 67 publications

References 31 publications

TNM Staging of Non–Small Cell Lung Cancer: Comparison of PET/MR and PET/CT

TNM Staging of Non–Small Cell Lung Cancer: Comparison of PET/MR and PET/CT

Lung Cancer

FDG Whole-Body PET/MRI in Oncology: a Systematic Review

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