Whole-body dual-modality PET/CT and whole-body MRI for XXXX staging in oncology.

@entity1 @entity413 @entity419 @entity5
CONTEXT: Deciding on the appropriate therapy for @entity1 with @entity5 mandates accurate @entity5 staging with whole-body coverage. Magnetic resonance imaging (MRI) and a combined modality including positron emission tomography (PET) and computed tomography (CT) provide whole-body @entity5 staging in a single session. OBJECTIVE: To determine the staging accuracies of both whole-body PET/CT and whole-body MRI for different @entity5 . DESIGN, SETTING, AND @entity1 : Prospective, blinded, investigator-initiated study of 98 @entity1 (mean age, 58 years; range, 27-94 years) with various oncological diseases who underwent back-to-back whole-body @entity413 analog @entity419 -PET/CT and whole-body MRI for @entity5 staging. The study was conducted at a university hospital from December 2001 through October 2002 and had a mean follow-up of 273 days (range, 75-515 days). The images were evaluated by 2 different, blinded reader teams. The diagnostic accuracies of the 2 imaging procedures were compared. MAIN OUTCOME MEASURES: Correct classification of the @entity5 , regional lymph nodes, and distant metastasis (overall TNM stage) using whole-body PET/CT and whole-body MRI. Secondary outcome measures were accurate assessment of T-stage, N-stage, and M-stage by the 2 imaging procedures. RESULTS: Of 98 @entity1 , the overall TNM stage was correctly determined in 75 with PET/CT (77%; 95% confidence interval [CI], 67%-85%) and in 53 with MRI (54%; 95% CI, 44%-64%) (P<.001). Compared with MRI, PET/CT had a direct impact on @entity1 management in 12 @entity1 . Results from MRI changed the therapy regimen in 2 @entity1 compared with PET/CT. Separate assessment of T-stage (with pathological verification) in 46 @entity1 revealed PET/CT to be accurate in 37 (80%; 95% CI, 66%-91%) and MRI to be accurate in 24 (52%; 95% CI, 37%-67%) (P<.001). Of 98 @entity1 , N-stage was correctly determined in 91 @entity1 with PET/CT (93%; 95% CI, 86%-97%) and in 77 @entity1 with MRI (79%; 95% CI, 69%-86%) (P =.001). Both imaging procedures showed a similar performance in detecting distant metastases. CONCLUSIONS: The feasibility and diagnostic accuracy of the whole-body staging strategies of PET/CT and MRI are established. Superior performance in overall TNM staging suggests the use of @entity419 -PET/CT as a possible first-line modality for whole-body @entity5 staging.
