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Comparison of 18F-FDG PET/MRI and MRI for pre-therapeutic tumor staging of patients with primary cancer of the uterine cervix.
Sarabhai, Theresia; Schaarschmidt, Benedikt M; Wetter, Axel; Kirchner, Julian; Aktas, Bahriye; Forsting, Michael; Ruhlmann, Verena; Herrmann, Ken; Umutlu, Lale; Grueneisen, Johannes.
Afiliação
  • Sarabhai T; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, D-45147, Essen, Germany. Theresia-catharina.sarabhai@uk-essen.de.
  • Schaarschmidt BM; Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225, Dusseldorf, Germany.
  • Wetter A; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, D-45147, Essen, Germany.
  • Kirchner J; Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225, Dusseldorf, Germany.
  • Aktas B; Department of Obstetrics and Gynecology, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany.
  • Forsting M; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, D-45147, Essen, Germany.
  • Ruhlmann V; Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany.
  • Herrmann K; Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany.
  • Umutlu L; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, D-45147, Essen, Germany.
  • Grueneisen J; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, D-45147, Essen, Germany.
Eur J Nucl Med Mol Imaging ; 45(1): 67-76, 2018 Jan.
Article em En | MEDLINE | ID: mdl-28840302
ABSTRACT

PURPOSE:

The aim of the present study was to assess and compare the diagnostic performance of integrated PET/MRI and MRI alone for local tumor evaluation and whole-body tumor staging of primary cervical cancers. In addition, the corresponding impact on further patient management of the two imaging modalities was assessed.

METHODS:

A total of 53 consecutive patients with histopathological verification of a primary cervical cancer were prospectively enrolled for a whole-body 18F-FDG PET/MRI examination. Two experienced physicians analyzed the MRI data, in consensus, followed by a second reading session of the PET/MRI datasets. The readers were asked to perform a dedicated TNM staging in accordance with the 7th edition of the AJCC staging manual. Subsequently, the results of MRI and PET/MRI were discussed in a simulated interdisciplinary tumor board and therapeutic decisions based on both imaging modalities were recorded. Results from histopathology and cross-sectional imaging follow-up served as the reference standard.

RESULTS:

PET/MRI allowed for a correct determination of the T stage in 45/53 (85%) cases, while MRI alone enabled a correct identification of the tumor stage in 46/53 (87%) cases. In 24 of the 53 patients, lymph node metastases were present. For the detection of nodal-positive patients, sensitivity, specificity and accuracy of PET/MRI were 83%, 90% and 87%, respectively. The respective values for MRI alone were 71%, 83% and 77%. In addition, PET/MRI showed higher values for the detection of distant metastases than MRI alone (sensitivity 87% vs. 67%, specificity 92% vs. 90%, diagnostic accuracy 91% vs. 83%). Among the patients with discrepant staging results in the two imaging modalities, PET/MRI enabled correct treatment recommendations for a higher number (n = 9) of patients than MRI alone (n = 3).

CONCLUSION:

The present results demonstrate the successful application of integrated PET/MRI imaging for whole-body tumor staging of cervical cancer patients, enabling improved treatment planning when compared to MRI alone.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Carcinoma / Neoplasias do Colo do Útero / Tomografia por Emissão de Pósitrons / Imagem Multimodal Tipo de estudo: Evaluation_studies / Guideline / Prognostic_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Carcinoma / Neoplasias do Colo do Útero / Tomografia por Emissão de Pósitrons / Imagem Multimodal Tipo de estudo: Evaluation_studies / Guideline / Prognostic_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article