Comparison of whole-body PET/CT and PET/MR in clinical diagnosis of malignant tumors
SUN Hong-zan1, DU Si-yao1, XIN Jun1, CHEN Zhong-wei2
1.Department of Radiology, Shengjing Hospital of China Medical University, Liaoning Provincial Key Laboratory of
Medical Imaging, Shenyang 110004, China; 2.GE Healthcare, Beijing 100176, China
Abstract：Objective: The aim of this study was to demonstrate stability and accuracy in tumor semiquantitative assessment of the integrated PET/MR by analyzing difference and correlation between PET/CT SUVmax and PET/MR SUVmax. Methods: Fifty-seven patients(22 males, 35 females, average age (54±12) years), who underwent same day whole-body PET/CT and PET/MR in Shengjing Hospital Affiliated to China Medical University, the time interval between the two scans was (78±35) minutes. Patients underwent the whole-body PET/CT and PET/MR from the base of skull to upper thighs, TOF-PET technique of GE company was used to reconstruct images and SUVmax was obtained by fusion images to delineate ROI of lesions and some normal tissues. The difference analysis of SUVmax were performed with Paired t test and the correlation was analyzed with Spearman correlation analysis. Results: 97 hypermetabolism lesions were detected by PET/CT, 100 hypermetabolism lesions were detected by PET/MR, a total of 96 hypermetabolism lesions were detected by two modalities. The PET/MR SUVmax of lesions was significantly higher than that of PET/CT SUVmax(P<0.0001) in the case of PET/CT and following PET/MR. The PET/MR SUVmax of most normal tissues significantly lower than that of PET/CT(P<0.0001), only the PET/MR SUVmax of psoas was slightly higher than that of PET/CT, but there was no statistical difference(P=0.056). The ratios of PET/MR SUVmax of the lesion and the normal tissues were significantly higher than PET/CT(P<0.0001). There were significant correlations of SUVmax between PET/MR and PET/CT for lesions(r=0.92, P<0.0001) and for normal tissues(lung r=0.64;liver r=0.87; spleen r=0.73; psoas r=0.57, P<0.0001). Conclusions: The SUVmax of PET/MR in tumor was significantly higher than that of PET/CT, which may be due to PET/MR technical advantages and delayed glucose uptake by malignant lesions. PET/MR and PET/CT SUVmax highly correlated, suggesting that integrated PET/MR on semiquantitative analysis of malignant tumor lesions has a very good stability and accuracy.
孙洪赞1，杜思瑶1，辛 军1，陈忠维2. PET/CT与PET/MR诊断恶性肿瘤的临床对照研究[J]. 中国临床医学影像杂志, 2018, 29(9): 655-659.
SUN Hong-zan1, DU Si-yao1, XIN Jun1, CHEN Zhong-wei2. Comparison of whole-body PET/CT and PET/MR in clinical diagnosis of malignant tumors. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(9): 655-659.
[1]王海鹏，樊馨，贠明凯，等. PET/MR衰减矫正技术研究进展[J]. 中国医学影像技术，2014，（2）：295-299.
[2]Ruhlmann V, Ruhlmann M, Bellendorf A, et al. Hybrid imaging for detection of carcinoma of unknown primary: a preliminary comparison trial of whole-body PET/MRI versus PET/CT[J]. Eur J Radiol, 2016, 85(11): 1941-1947.
[3]Tian J, Fu L, Yin D, et al. Does the novel integrated PET/MRI offer the same diagnostic performance as PET/CT for oncological indications?[J]. PLoS One, 2014, 9(3): e90844.
[4]Wiesmüller M, Quick HH, Navalpakkam B, et al. Comparison of lesion detection and quantitation of tracer uptake between PET from a simultaneously acquiring whole-body PET/MR hybrid scanner and PET from PET/CT[J]. Eur J Nucl Med Mol Imaging, 2013, 40(1): 12-21.
[5]Beiderwellen K, Huebner M, Heusch P, et al. Whole-body (18F)FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results[J]. Eur Radiol, 2014, 24(8): 2023-2030.
[6]Heusch P, Buchbender C, Kohler J, et al. Thoracic staging in lung cancer: prospective comparison of 18F-FDG PET/MR imaging and 18F-FDG PET/CT[J]. J Nucl Med, 2014, 55(3): 373-378.
[7]Drzezga A, Souvatzoglou M, Eiber M, et al. First clinical experience with integrated whole-body PET/MR: comparison to PET/CT in patients with oncologic diagnoses[J]. J Nucl Med, 2012, 53(6): 845-855.
[8]Giraudo C, Raderer M, Karanikas G, et al. 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance in lymphoma: comparison with 18F-fluorodeoxyglucose positron emission tomography/computed tomography and with the addition of magnetic resonance diffusion-weighted imaging[J]. Invest Radiol, 2016, 51(3): 163-169.
[9]徐白萱，富丽萍，关志伟，等. PET/MR与PET/CT的对比研究[J]. 中华核医学与分子影像杂志，2014，34（6）：423-427.
[10]Beiderwellen K, Geraldo L, Ruhlmann V, et al. Accuracy of [18F]FDG PET/MRI for the detection of liver metastases[J]. PLoS One, 2015, 10(9): e0137285.
[11]Iagaru A, Mittra E, Minamimoto R, et al. Simultaneous whole-body time-of-flight 18F-FDG PET/MRI: a pilot study comparing SUVmax with PET/CT and assessment of MR image quality[J]. Clin Nucl Med, 2015, 40(1): 1-8.
[12]Pace L, Nicolai E, Luongo A, et al. Comparison of whole-body PET/CT and PET/MRI in breast cancer patients: lesion detection and quantitation of 18F-deoxyglucose uptake in lesions and in normal organ tissues[J]. Eur J Radiol, 2014, 83(2): 289-296.
[13]Martinez-Moller A, Souvatzoglou M, Delso G, et al. Tissue classification as a potential approach for attenuation correction in whole-body PET/MRI: evaluation with PET/CT data[J]. J Nucl Med, 2009, 50(4): 520-526.
[14]Matthies A, Hickeson M, Cuchiara A, et al. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules[J]. J Nucl Med, 2002, 43(7): 871-875.
[15]Zytoon AA, Murakami K, El-Kholy MR, et al. Dual time point FDG-PET/CT imaging. Potential tool for diagnosis of breast cancer[J]. Clin Radiol, 2008, 63(11): 1213-1227.
[16]Paspulati RM, Partovi S, Herrmann KA, et al. Comparison of hybrid FDG PET/MRI compared with PET/CT in colorectal cancer staging and restaging: a pilot study[J]. Abdom Imaging, 2015, 40(6): 1415-1425.
[17]Heusch P, Buchbender C, Beiderwellen K, et al. Standardized uptake values for [18F] FDG in normal organ tissues: Comparison of whole-body PET/CT and PET/MRI[J]. Eur J Radiol, 2013, 82(5): 870-876.
2018, Vol. 29 
