Evaluation of a Fast Protocol for Staging Lymphoma Patients with Integrated PET/MRI
نویسندگان
چکیده
BACKGROUND The aim of this study was to assess the applicability of a fast MR-protocol for whole-body staging of lymphoma patients using an integrated PET/MR system. METHODS A total of 48 consecutive lymphoma patients underwent 52 clinically indicated PET/CT and subsequent PET/MRI examinations with the use of 18F-FDG. For PET/MR imaging, a fast whole-body MR-protocol was implemented. A radiologist and a nuclear medicine physician interpreted MRI and PET/MRI datasets in consensus and were instructed to identify manifestations of lymphoma on a site-specific analysis. The accuracy for the identification of active lymphoma disease was calculated and the tumor stage for each examination was determined. Furthermore, radiation doses derived from administered tracer activities and CT protocol parameters were estimated and the mean scan duration of PET/CT and PET/MR imaging was determined. Statistical analysis was performed to compare the diagnostic performance of PET/MRI and MRI alone. The results of PET/CT imaging, all available histopathological samples as well as results of prior examinations and follow-up imaging were used for the determination of the reference standard. RESULTS Active lymphoma disease was present in 28/52 examinations. PET/MRI revealed higher values of diagnostic accuracy for the identification of active lymphoma disease in those 52 examinations in comparison to MRI, however, results of the two ratings did not differ significantly. On a site specific analysis, PET/MRI showed a significantly higher accuracy for the identification of nodal manifestation of lymphoma (p<0.05) if compared to MRI, whereas ratings for extranodal regions did not reveal a significant difference. In addition, PET/MRI enabled correct identification of lymphoma stage in a higher percentage of patients than MRI (94% vs. 83%). Furthermore, SUVs derived from PET/MRI were significantly higher than in PET/CT, however, there was a strong positive correlation between SUVmax and SUVmean of the two imaging modalities (R = 0.91 p<0.001 and R = 0.87, p<0.001). Average scan duration of whole-body PET/CT and PET/MRI examinations amounted to 17.3±1.9 min and 27.8±3.7 min, respectively. Estimated mean effective-dose for whole-body PET/CT scans were 64.4% higher than for PET/MRI. CONCLUSIONS Our results demonstrate the usefulness of 18F-FDG PET data as a valuable additive to MRI for a more accurate evaluation of patients with lymphomas. With regard to patient comfort related to scan duration and a markedly reduced radiation exposure, fast PET/MRI may serve as a powerful alternative to PET/CT for a diagnostic workup of lymphoma patients.
منابع مشابه
Prognostic Value of FDG-PET, Based on the Revised Response Criteria, in Patients with Malignant Lymphoma: A Comparison with CT/MRI Evaluations, Based on the International Working Group/ Cotswolds Meeting Criteria
Objective(s): Post-treatment evaluations by CT/MRI (based on the International Working Group/ Cotswolds meeting guidelines) and PET (based on Revised Response Criteria), were examined in terms of progression-free survival (PFS) in patients with malignant lymphoma (ML). Methods: 79 patients, undergoing CT/MRI for the examination of suspected lesions and whole-body PET/CT before and after therapy...
متن کاملImaging, Diagnosis, Prognosis Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients
Purpose: To determine the value of diffusion-weighted MRI (DWI-MRI) for pretherapeutic imaging of fluorodeoxyglucose (FDG)-avid lymphoma and lymphoma with variable FDG avidity. Experimental Design: Treatment-na€ ve patients with lymphoma who were referred for whole-body staging were included in this prospective study. Group A included patients with FDG-avid lymphoma (e.g., Hodgkin, diffuse larg...
متن کامل[68Ga]Ga-PSMA-11 PET/CT for staging and patient management of high-risk prostate cancer: A single-center experience from Iran
Introduction: Accurate staging plays an important role in management of patients with prostate cancer especially in high-risk group. Today, [68Ga]Ga-PSMA-11 PET/CT should be considered as the preferred imaging tool for treatment planning and initial staging of the disease. Methods: A total number of 628 patients with prostate cancer referred to...
متن کاملHybrid PET/MRI for Evaluation of Nodal Disease in Lymphoma
Introduction: Non Hodgkin Lymphoma (NHL) is a common hematologic malignancy accounting for 4% all cancers in United States. It is estimated that nearly 70,000 patients will be diagnosed with NHL in 2013, and 19,000 will die from this disease. 18-F FDG PET combined with anatomic CT imaging has been shown to be superior to contrast enhanced CT examination in staging of lymphoma. Thus PET/CT is ro...
متن کاملOncologic PET/MRI, part 2: bone tumors, soft-tissue tumors, melanoma, and lymphoma.
With integrated whole-body PET/MRI, a novel metabolic-anatomic imaging technique recently has been introduced into clinical practice. This review addresses PET/MRI of bone tumors, soft-tissue sarcoma, melanoma, and lymphoma. If PET/MRI literature is not yet available for some types of tumors, potential indications are based on available PET/CT and MRI data. PET/MRI seems to be of benefit in T-s...
متن کامل