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Kızıloğlu HA, Karaman A, Dilek O, Kasali K, Alper F. Evaluation of pulmonary nodules by magnetic resonance imaging sequences: which sequence will replace computed tomography? Rev Assoc Med Bras (1992) 2022; 68:1519-1523. [PMID: 36449768 PMCID: PMC9720765 DOI: 10.1590/1806-9282.20220215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study aimed to determine the role of magnetic resonance imaging in minimizing radiation exposure, especially in the follow-up of pulmonary nodules. METHODS Patients who applied to our hospital between April 2013 and August 2018 for various reasons and had lung-mediastinal dynamic magnetic resonance imaging and thoracic computed tomography were included in the study. A total of 194 patients were included in the study, involving 84 females and 110 males. Scanning of the nodules was done retrospectively. This study was conducted by two readers: a thoracic radiologist with 15 years of experience and a nonspecific radiologist with 4 years of experience. Evaluations were made using the double-blind method. RESULTS Of the 194 patients, 84 (43.3%) were female and 110 (56.7%) were male. For the first reader, 135 (69.5%) nodules were detected in postcontrast T1 vibe images, 130 (67%) in T2 fast spin echo, 128 (66%) in precontrast T1 vibe, and 98 (50.5%) in T2 turbo inversion recovery magnitude sequence. For the second reader, 133 (68%) nodules were detected in postcontrast T1 vibe images, 120 (61.9%) in T2 fast spin echo, 122 (62.9%) in precontrast T1 vibe, and 99 (51%) in T2 turbo inversion recovery magnitude sequence. Capability levels were examined in detecting nodules between the first and second readers, and the ratios were reached at 0.92 in T2 fast spin echo, 0.81 in postcontrast T1 vibe images, 0.93 in precontrast T1 vibe, and 0.96 in T2 turbo inversion recovery magnitude sequence. CONCLUSION In this study of detecting pulmonary nodules by magnetic resonance imaging, which we performed with two different readers, one of whom was an experienced thoracic radiologist, both readers found the highest detection rate in the postcontrast T1 vibe sequence.
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Yang S, Shan F, Shi Y, Liu T, Wang Q, Zhang H, Zhang X, Yang S, Zhang Z. Sensitivity and specificity of magnetic resonance imaging in routine diagnosis of pulmonary lesions: a comparison with computed tomography. J Thorac Dis 2022; 14:3762-3772. [PMID: 36389319 PMCID: PMC9641349 DOI: 10.21037/jtd-22-370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/26/2022] [Indexed: 12/21/2024]
Abstract
BACKGROUND State-of-the-art thoracic magnetic resonance imaging (MRI) plays a complementary role in the assessment of pulmonary nodules/masses which potentially indicate to cancer. We aimed to evaluate the sensitivity and specificity of MRI in diagnosis of pulmonary nodules/masses. METHODS Sixty-eight patients with computed tomography (CT)-detected pulmonary nodules/masses underwent 3T MRI (T1-VIBE, T1-starVIBE, T2-fBLADE turbo spin-echo, and T2-SPACE). The detection rate was calculated for each of the different subgroups of pulmonary nodules according to lung imaging reporting and data system (Lung-RADS). The four MRI sequences were compared in terms of detection rate and image quality-signal to noise ratio (SNR), contrast to noise ratio (CNR) and 5-point scoring scale. Agreement of lesion size measurement between CT and MRI was assessed by intraclass correlation coefficient (ICC). The picture-SNR, lesion-SNR and CNR of each sequence were analyzed by Mann-Whitney U test. RESULTS In total, 232 pulmonary lesions were detected by CT. The CT showed 86 solid nodules (SNs) <6 mm, 15 SNs between 6-8 mm, 35 SNs between 8-15 mm, and 52 SNs between 15-30 mm. The T1-VIBE, T1-starVIBE, T2-fBLADE TSE and T2-SPACE sequences accurately detected 141 SNs (141/188, 75%/83.3%), 150 SNs (150/188, 79.8%/100%), 166 SNs (166/188, 88.3%/66.7%) and 169 SNs (169/188, 89.9%/53.3%), respectively. Four ground glass nodules (GGNs) (4/6) were detected by T2-fBLADE TSE. Twelve part-solid nodules (PSNs) (12/22) were detected by T1-VIBE and 20 PSNs (20/22) by T2-SPACE. A total of 100 lesions (2.2±1.4 cm, 0.8-7.3 cm) were accurately detected and measured by the four MRI sequences with ICC >0.96. The picture-SNR, lesion-SNR and CNR by T1-starVIBE were higher than those by T1-VIBE (P<0.001). The lesion-SNR and CNR by T2-fBLADE TSE were higher than those by T2-SPACE (P=0.006, 0.038). 86% of images by T1-starVIBE, 92% by T2-fBLADE TSE, 90% by T2-SPACE and 93% by T1-VIBE were scored 3 or more. CONCLUSIONS MRI achieves high sensitivity and specificity for different type of pulmonary nodules detection and is an effective alternative to CT as a diagnostic tool for pulmonary nodules.
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Affiliation(s)
- Shuyi Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Fei Shan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yuxin Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tiefu Liu
- Department of Scientific Research, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qingle Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Haoling Zhang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xingwei Zhang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shan Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhiyong Zhang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Bruckmann NM, Kirchner J, Morawitz J, Umutlu L, Fendler WP, Herrmann K, Bittner AK, Hoffmann O, Fehm T, Lindemann ME, Buchbender C, Antoch G, Sawicki LM. Free-breathing 3D Stack of Stars GRE (StarVIBE) sequence for detecting pulmonary nodules in 18F-FDG PET/MRI. EJNMMI Phys 2022; 9:11. [PMID: 35129774 PMCID: PMC8821742 DOI: 10.1186/s40658-022-00439-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/24/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The free-breathing T1-weighted 3D Stack of Stars GRE (StarVIBE) MR sequence potentially reduces artifacts in chest MRI. The purpose of this study was to evaluate StarVIBE for the detection of pulmonary nodules in 18F-FDG PET/MRI. MATERIAL AND METHODS In this retrospective analysis, conducted on a prospective clinical trial cohort, 88 consecutive women with newly diagnosed breast cancer underwent both contrast-enhanced whole-body 18F-FDG PET/MRI and computed tomography (CT). Patients' chests were examined on CT as well as on StarVIBE and conventional T1-weighted VIBE and T2-weighted HASTE MR sequences, with CT serving as the reference standard. Presence, size, and location of all detectable lung nodules were assessed. Wilcoxon test was applied to compare nodule features and Pearson's, and Spearman's correlation coefficients were calculated. RESULTS Out of 65 lung nodules detected in 36 patients with CT (3.7 ± 1.4 mm), StarVIBE was able to detect 31 (47.7%), VIBE 26 (40%) and HASTE 11 (16.8%), respectively. Overall, CT showed a significantly higher detectability than all MRI sequences combined (65 vs. 36, difference 44.6%, p < 0.001). The VIBE showed a significantly better detection rate than the HASTE (23.1%, p = 0.001). Detection rates between StarVIBE and VIBE did not significantly differ (7.7%, p = 0.27), but the StarVIBE showed a significant advantage detecting centrally located pulmonary nodules (66.7% vs. 16.7%, p = 0.031). There was a strong correlation in nodule size between CT and MRI sequences (HASTE: ρ = 0.80, p = 0.003; VIBE: ρ = 0.77, p < 0.001; StarVIBE: ρ = 0.78, p < 0.001). Mean image quality was rated as good to excellent for CT and MRI sequences. CONCLUSION The overall lung nodule detection rate of StarVIBE was slightly, but not significantly, higher than conventional T1w VIBE and significantly higher than T2w HASTE. Detectability of centrally located nodules is better with StarVIBE than with VIBE. Nevertheless, all MRI analyses demonstrated considerably lower detection rates for small lung nodules, when compared to CT.
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Affiliation(s)
- Nils Martin Bruckmann
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Janna Morawitz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen and German Cancer Consortium (DKTK), Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen and German Cancer Consortium (DKTK), Essen, Germany
| | - Ann-Kathrin Bittner
- Department Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Oliver Hoffmann
- Department Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Tanja Fehm
- Department of Gynecology, Medical Faculty, University Dusseldorf, 40225, Düsseldorf, Germany
| | - Maike E Lindemann
- High-Field and Hybrid MR Imaging, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Christian Buchbender
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Lino M Sawicki
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
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Abstract
PET/MR imaging is in routine clinical use and is at least as effective as PET/CT for oncologic and neurologic studies with advantages with certain PET radiopharmaceuticals and applications. In addition, whole body PET/MR imaging substantially reduces radiation dosages compared with PET/CT which is particularly relevant to pediatric and young adult population. For cancer imaging, assessment of hepatic, pelvic, and soft-tissue malignancies may benefit from PET/MR imaging. For neurologic imaging, volumetric brain MR imaging can detect regional volume loss relevant to cognitive impairment and epilepsy. In addition, the single-bed position acquisition enables dynamic brain PET imaging without extending the total study length which has the potential to enhance the diagnostic information from PET.
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Affiliation(s)
- Farshad Moradi
- Department of Radiology, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA 94305, USA.
| | - Andrei Iagaru
- Department of Radiology, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA 94305, USA
| | - Jonathan McConathy
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, JT 773, Birmingham, AL 35249, USA
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Polycarpou I, Soultanidis G, Tsoumpas C. Synergistic motion compensation strategies for positron emission tomography when acquired simultaneously with magnetic resonance imaging. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200207. [PMID: 34218675 PMCID: PMC8255946 DOI: 10.1098/rsta.2020.0207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 05/04/2023]
Abstract
Subject motion in positron emission tomography (PET) is a key factor that degrades image resolution and quality, limiting its potential capabilities. Correcting for it is complicated due to the lack of sufficient measured PET data from each position. This poses a significant barrier in calculating the amount of motion occurring during a scan. Motion correction can be implemented at different stages of data processing either during or after image reconstruction, and once applied accurately can substantially improve image quality and information accuracy. With the development of integrated PET-MRI (magnetic resonance imaging) scanners, internal organ motion can be measured concurrently with both PET and MRI. In this review paper, we explore the synergistic use of PET and MRI data to correct for any motion that affects the PET images. Different types of motion that can occur during PET-MRI acquisitions are presented and the associated motion detection, estimation and correction methods are reviewed. Finally, some highlights from recent literature in selected human and animal imaging applications are presented and the importance of motion correction for accurate kinetic modelling in dynamic PET-MRI is emphasized. This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 2'.
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Affiliation(s)
- Irene Polycarpou
- Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus
| | - Georgios Soultanidis
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charalampos Tsoumpas
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Biomedical Imaging Science Department, University of Leeds, West Yorkshire, UK
- Invicro, London, UK
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Biondetti P, Vangel MG, Lahoud RM, Furtado FS, Rosen BR, Groshar D, Canamaque LG, Umutlu L, Zhang EW, Mahmood U, Digumarthy SR, Shepard JAO, Catalano OA. PET/MRI assessment of lung nodules in primary abdominal malignancies: sensitivity and outcome analysis. Eur J Nucl Med Mol Imaging 2021; 48:1976-1986. [PMID: 33415433 DOI: 10.1007/s00259-020-05113-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/08/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To evaluate PET/MR lung nodule detection compared to PET/CT or CT, to determine growth of nodules missed by PET/MR, and to investigate the impact of missed nodules on clinical management in primary abdominal malignancies. METHODS This retrospective IRB-approved study included [18F]-FDG PET/MR in 126 patients. All had standard of care chest imaging (SCI) with diagnostic chest CT or PET/CT within 6 weeks of PET/MR that served as standard of reference. Two radiologists assessed lung nodules (size, location, consistency, position, and [18F]-FDG avidity) on SCI and PET/MR. A side-by-side analysis of nodules on SCI and PET/MR was performed. The nodules missed on PET/MR were assessed on follow-up SCI to ascertain their growth (≥ 2 mm); their impact on management was also investigated. RESULTS A total of 505 nodules (mean 4 mm, range 1-23 mm) were detected by SCI in 89/126 patients (66M:60F, mean age 60 years). PET/MR detected 61 nodules for a sensitivity of 28.1% for patient and 12.1% for nodule, with higher sensitivity for > 7 mm nodules (< 30% and > 70% respectively, p < 0.05). 75/337 (22.3%) of the nodules missed on PET/MR (follow-up mean 736 days) demonstrated growth. In patients positive for nodules at SCI and negative at PET/MR, missed nodules did not influence patients' management. CONCLUSIONS Sensitivity of lung nodule detection on PET/MR is affected by nodule size and is lower than SCI. 22.3% of missed nodules increased on follow-up likely representing metastases. Although this did not impact clinical management in study group with primary abdominal malignancy, largely composed of extra-thoracic advanced stage cancers, with possible different implications in patients without extra-thoracic spread.
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Affiliation(s)
- Pierpaolo Biondetti
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Mark G Vangel
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, 60 Staniford St, Boston, MA, USA
| | - Rita M Lahoud
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Felipe S Furtado
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Bruce R Rosen
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David Groshar
- Department of Nuclear Medicine, Assuta Medical Centers, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lina G Canamaque
- Department of Nuclear Medicine. Grupo HM Hospitales, Madrid, Spain
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Eric W Zhang
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Umar Mahmood
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Subba R Digumarthy
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Jo-Anne O Shepard
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Onofrio A Catalano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA.
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Moradi F, Brunsing RL, Sheth VR, Iagaru A. Positron Emission Tomography–Magnetic Resonance Imaging. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
In academic centers, PET/MR has taken the road to clinical nuclear medicine in the past 6 years since the last review on its applications in head and neck cancer patients in this journal. Meanwhile, older sequential PET + MR machines have largely vanished from clinical sites, being replaced by integrated simultaneous PET/MR scanners. Evidence from several studies suggests that PET/MR overall performs equally well as PET/CT in the staging and restaging of head and neck cancer and in radiation therapy planning. PET/MR appears to offer advantages in the characterization and prognostication of head and neck malignancies through multiparametric imaging, which demands an exact preparation and validation of imaging modalities, however. The majority of available clinical PET/MR studies today covers FDG imaging of squamous cell carcinoma arising from a broad spectrum of locations in the upper aerodigestive tract. In the future, specific PET/MR studies are desired that address specific histopathological tumor entities, nonepithelial malignancies, such as major salivary gland tumors, squamous cell carcinomas arising in specific locations, and malignancies imaged with non-FDG radiotracers. With the advent of digital PET/CT scanners, PET/MR is expected to partake in future technical developments, such as novel iterative reconstruction techniques and deviceless motion correction for respiration and gross movement in the head and neck region. Owing to the still comparably high costs of PET/MR scanners and facility requirements on the one hand, and the concentration of multidisciplinary head and neck cancer treatment mainly at academic centers on the other hand, a more widespread use of this imaging modality outside major hospitals is currently limited.
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Diagnostic performance of zero-TE lung MR imaging in FDG PET/MRI for pulmonary malignancies. Eur Radiol 2020; 30:4995-5003. [PMID: 32300969 PMCID: PMC7431435 DOI: 10.1007/s00330-020-06848-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/10/2020] [Accepted: 03/30/2020] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study aimed to evaluate the diagnostic performance of the lung zero-echo time (ZTE) sequence in FDG PET/MRI for detection and differentiation of lung lesions in oncologic patients in comparison with conventional two-point Dixon-based MR imaging. METHODS In this single-institution retrospective study approved by the institutional review board, 209 patients with malignancies (97 men and 112 women; age range, 17-89 years; mean age, 66.5 ± 12.9 years) underwent 18F-FDG PET/MRI between August 2017 and August 2018, with diagnostic Dixon and ZTE under respiratory gating acquired simultaneously with PET. Image analysis was performed for PET/Dixon and PET/ZTE fused images by two readers to assess the detectability and differentiation of lung lesions. The reference standard was pathological findings and/or the data from a chest CT. The detection and differentiation abilities were evaluated for all lesions and subgroups divided by lesion size and maximum standardized uptake value (SUVmax). RESULTS Based on the reference standard, 227 lung lesions were identified in 113 patients. The detectability of PET/ZTE was significantly better than that of PET/Dixon for overall lesions, lesions with a SUVmax less than 3.0 and lesions smaller than 4 mm (p < 0.01). The diagnostic performance of PET/ZTE was significantly better than that of PET/Dixon for overall lesions and lesions smaller than 4 mm (p < 0.01). CONCLUSIONS ZTE can improve diagnostic performance in the detection and differentiation of both FDG-avid and non-FDG-avid lung lesions smaller than 4 mm in size, yielding a promising tool to enhance the utility of FDG PET/MRI in oncology patients with lung lesions. KEY POINTS • The detection rate of PET/ZTE for lesions with a SUVmax of less than 1.0 was significantly better than that of PET/Dixon. • The performance for differentiation of PET/ZTE for lesions that were even smaller than 4 mm in size were significantly better than that of PET/Dixon. • Inter-rater agreement of PET/ZTE for the differentiation of lesions less than 4 mm in size was substantial and better than that of PET/Dixon.
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Mapelli P, Ironi G, Fallanca F, Partelli S, Muffatti F, Andreasi V, Gianolli L, Falconi M, De Cobelli F, Picchio M. 68Ga-DOTA-peptides PET/MRI in pancreatico-duodenal neuroendocrine tumours: a flash pictorial essay on assets and lacks. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00341-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Murphy DJ, Mak SM, Mallia A, Jeljeli S, Stirling JJ, Goh V, Bille A, Cook GJR. Loco-regional staging of malignant pleural mesothelioma by integrated 18F-FDG PET/MRI. Eur J Radiol 2019; 115:46-52. [PMID: 31084758 DOI: 10.1016/j.ejrad.2019.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/04/2019] [Accepted: 04/04/2019] [Indexed: 01/21/2023]
Abstract
AIM To examine the performance of 18F-FDG PET/MRI in the loco-regional staging of malignant pleural mesothelioma (MPM). METHODS Consecutive subjects with MPM undergoing pre-operative staging with 18F-FDG PET/CT who underwent a same day integrated 18F-FDG PET/MRI were prospectively studied. Clinical TNM staging (AJCC 7th edition) was performed separately and in consensus by two readers on the 18F-FDG PET/MRI studies, and compared with staging by 18F-FDG PET/CT, and with final pathological stage, determined by a combination of intra-operative and histological findings. RESULTS 10 subjects (9 male, mean age 68 years) with biopsy-proven MPM (9 epithelioid tumours, 1 biphasic) were included. One subject underwent neo-adjuvant chemotherapy between imaging and surgery and was excluded from the clinical versus pathological stage analysis. Pathological staging was concordant with staging by 18F-FDG PET/MRI in 67% (n = 6) of subjects, and with 18F-FDG PET/CT staging in 33% (n = 3). Pathological T stage was concordant with 18F-FDG PET/MRI in 78% (n = 7), and with 18F-FDG PET/CT in 33% (n = 3) of subjects. Pathological N stage was concordant with both 18F-FDG PET/MRI and 18F-FDG PET/CT in 78% (n = 7) of cases. No subject had metastatic disease. There was good inter-observer agreement for overall PET/MRI staging (weighted kappa 0.63) with moderate inter-reader agreement for T staging (weighted kappa 0.59). All 6 subjects with prior talc pleurodesis demonstrated mismatch between elevated FDG uptake and restricted diffusion in areas of visible talc deposition. CONCLUSION Clinical MPM staging by 18F-FDG PET/MRI is feasible, and potentially provides more accurate loco-regional staging than PET/CT, particularly in T staging.
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Affiliation(s)
- D J Murphy
- King's College London & Guy's and St Thomas' PET Centre, London UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London UK.
| | - S M Mak
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London UK
| | - A Mallia
- King's College London & Guy's and St Thomas' PET Centre, London UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London UK
| | - S Jeljeli
- King's College London & Guy's and St Thomas' PET Centre, London UK
| | - J J Stirling
- King's College London & Guy's and St Thomas' PET Centre, London UK
| | - V Goh
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London UK; Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London UK
| | - A Bille
- Department of Cardiothoracic Surgery, Guy's and St Thomas' NHS Foundation Trust, London UK
| | - G J R Cook
- King's College London & Guy's and St Thomas' PET Centre, London UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London UK
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Messerli M, de Galiza Barbosa F, Marcon M, Muehlematter UJ, Stolzmann P, Warschkow R, Delso G, ter Voert EEGW, Huellner MW, Frauenfelder T, Veit-Haibach P. Value of PET/MRI for assessing tumor resectability in NSCLC-intra-individual comparison with PET/CT. Br J Radiol 2019; 92:20180379. [PMID: 30209954 PMCID: PMC6435071 DOI: 10.1259/bjr.20180379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/22/2018] [Accepted: 09/05/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The purpose of this study was to compare the diagnostic accuracy of positron emission tomography (PET)/MRI with PET/CT for determining tumor resectability of non-small cell lung cancer (NSCLC). METHODS Sequential trimodality PET/CT/MRI was performed in 36 patients referred with the clinical question of resectability assessment in NSCLC. PET/CT and PET/MR images including T1 weighted sequence (T1-Dixon) and respiration gated T2 weighted sequence (T2-Propeller) were evaluated for resectability-defining factors; i.e. longest diameter of the tumor, minimal tumor distance to the carina, mediastinal invasion, invasion of the carina, pleural infiltration, pericardial infiltration, diaphragm infiltration, presence of additional nodules. RESULTS There was no significant difference of maximal axial diameter measurements of the primary lung tumors and narrow limits of agreement in Bland-Altman analysis ranging from -11.1 mm to + 11.8 mm for T2-Propeller and from -14.3 mm to + 13.8 mm for T1-Dixon sequence. A high agreement of PET/MR with PET/CT for the different resectability-defining factors was observed (k from 0.769 to 1.000). There was an excellent agreement of T2-Propeller sequence and CT for additional pulmonary nodule detection (k of 0.829 and 0.833), but only a moderate and good agreement using T1-Dixon sequence (k of 0.484 and 0.722). CONCLUSION In NSCLC the use of PET/MRI, including a dedicated pulmonary MR imaging protocol, provides a comparable diagnostic value for determination of tumor resectability compared to PET/CT. ADVANCES IN KNOWLEDGE Our findings suggest that whole body PET/MRI can safely be used for the local staging of NSCLC patients. Further studies are warranted to determine whether it is feasible to integrate an imaging sequence in a whole body PET/MRI setting with the potential advantage of detection of liver or brain metastases.
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Affiliation(s)
- Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland
| | - Felipe de Galiza Barbosa
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland
| | - Magda Marcon
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich/University Zurich, Zurich, Switzerland
| | | | - Paul Stolzmann
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland
| | - René Warschkow
- Departmentof Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | | | - Edwin EGW ter Voert
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland
| | - Thomas Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich/University Zurich, Zurich, Switzerland
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