Value of PET/MRI for assessing tumor resectability in NSCLC-intra-individual comparison with PET/CT.

Autor: Messerli M; 1Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland., de Galiza Barbosa F; 1Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland., Marcon M; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich/University Zurich, Zurich, Switzerland., Muehlematter UJ; 1Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland.; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich/University Zurich, Zurich, Switzerland., Stolzmann P; 1Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland., Warschkow R; 3Departmentof Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland., Delso G; GE Healthcare, Waukesha, WI, USA., Ter Voert EE; 1Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland., Huellner MW; 1Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland., Frauenfelder T; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich/University Zurich, Zurich, Switzerland., Veit-Haibach P; 1Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Zurich, Switzerland.; Joint Department Medical Imaging, University Health Network, University of Toronto, Toronto, ON, Canada.
Jazyk: angličtina
Zdroj: The British journal of radiology [Br J Radiol] 2019 Jan; Vol. 92 (1093), pp. 20180379. Date of Electronic Publication: 2018 Oct 11.
DOI: 10.1259/bjr.20180379
Abstrakt: 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 T 1 weighted sequence ( T 1 -Dixon) and respiration gated T 2 weighted sequence ( T 2 -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 T 2 -Propeller and from -14.3  mm to + 13.8  mm for T 1 -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 T 2 -Propeller sequence and CT for additional pulmonary nodule detection ( k of 0.829 and 0.833), but only a moderate and good agreement using T 1 -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.
Competing Interests: Conflict of interestPatrick Veit-Haibach received investigator-initiated study grants from Bayer Healthcare, GE Healthcare and Roche Pharmaceuticals, and speaker fees from GE Healthcare. Gaspar Delso is an employee of GE Healthcare. Martin Huellner received speaker’s fees from GE Healthcare. The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. There was financial support for this study from GE Healthcare on an institutional level. Only non-GE Healthcare employees had control of inclusion of the data and information that might present a conflict of interest for those authors who are employees of GE Healthcare.
Databáze: MEDLINE
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