Simulation of a MR-PET protocol for staging of head-and-neck cancer including Dixon MR for attenuation correction.
Eur J Radiol
; 81(10): 2658-65, 2012 Oct.
Article
em En
| MEDLINE
| ID: mdl-22078793
ABSTRACT
PURPOSE:
To simulate and optimize a MR protocol for squamous cell cancer of the head and neck (HNSCC) patients for potential future use in an integrated whole-body MR-PET scanner. MATERIALS ANDMETHODS:
On a clinical 3T scanner, which is the basis for a recently introduced fully integrated whole-body MR-PET, 20 patients with untreated HNSCC routinely staged with 18F-FDG PET/CT underwent a dedicated MR protocol for the neck. Moreover, a whole-body Dixon MR-sequence was applied, which is used for attenuation correction on a recently introduced hybrid MR-PET scanner. In a subset of patients volume-interpolated-breathhold (VIBE) T1w-sequences for lungs and liver were added. Total imaging time was analyzed for both groups. The quality of the delineation of the primary tumor (scale 0-3) and the presence or absence of lymph node metastases (scale 1-5) was evaluated for CT, MR, PET/CT and a combination of MR and PET to ensure that the MR-PET fusion does not cause a loss of diagnostic capability. PET was used to identify distant metastases. The PET dataset for simulated MR/PET was based on a segmentation of the CT data into 4 classes according to the approach of the Dixon MR-sequence for MR-PET. Standard of reference was histopathology in 19 cases. In one case no histopathological confirmation of a primary tumor could be achieved.RESULTS:
Mean imaging time was 3517 min (range 3108-4242 min) for the protocol including sequences for local staging and attenuation correction and 4417 min (range 3544-5458) for the extended protocol. Although not statistically significant a combination of MR and PET performed better in the delineation of the primary tumor (mean 2.20) compared to CT (mean 1.40), MR (1.95) and PET/CT (2.15) especially in patients with dental implants. PET/CT and combining MR and PET performed slightly better than CT and MR for the assessment of lymph node metastases. Two patients with distant metastases were only identified by PET.CONCLUSION:
We established a potential MR-protocol to be used for HNSCC patients in a recently introduced MR-PET scanner. The proposed protocol can be performed in an acceptable time frame and did not lead to a loss of diagnostic capability compared to PET/CT.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
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Interpretação de Imagem Assistida por Computador
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Carcinoma de Células Escamosas
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Técnica de Subtração
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Artefatos
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Tomografia por Emissão de Pósitrons
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Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Diagnostic_studies
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Guideline
/
Prognostic_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Radiol
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Alemanha