Diagnostic impact of integrated 18F-FDG PET/MRI in cerebral staging of patients with non-small cell lung cancer.
Background Integrated positron emission tomography/magnetic resonance imaging (PET/MRI) systems are increasingly being available and used for staging examinations. Brain metastases (BM) are frequent in patients with non-small cell lung cancer (NSCLC) and decisive for treatment strategy. Purpose To assess the diagnostic value of integrated 18F-2-fluoro-2-deoxy-D glucose (18F-FDG) PET/MRI in initial staging in patients with NSCLC for BM in comparison to MRI alone. Material and Methods Eighty-three patients were prospectively enrolled for an integrated 18F-FDG PET/MRI examination. The 3 T MRI protocol included a fluid-attenuated inversion-recovery sequence (FLAIR) and a contrast-enhanced three-dimensional magnetization prepared rapid acquisition GRE sequence (MPRAGE). Two neuroradiologists evaluated the datasets in consensus regarding: (i) present lesions; (ii) size of lesions; and (iii) number of lesions detected in MRI alone, compared to the PET component when reading the 18F-FDG PET/MRI. Results Based on MRI alone, BM were detected in 15 out of the 83 patients, comprising a total of 39 metastases. Based on PET alone, six patients out of the 83 patients were rated positive for metastatic disease, revealing a total of 15 metastases. PET detected no additional BM. The size of the BM correlated positively with sensitivity of detection in PET. Conclusion The sensitivity of PET in detection of BM depends on their size. 18F-FDG PET/MRI does not lead to an improvement in diagnostic accuracy in cerebral staging of NSCLC patients, as MRI alone remains the gold standard.
['Deuschl|Cornelius|C|', 'Nensa|Felix|F|', 'Grueneisen|Johannes|J|', 'Poeppel|Thorsten D|TD|', 'Sawicki|Lino M|LM|', 'Heusch|Philipp|P|', 'Gramsch|Carolin|C|', 'Mönninghoff|Christoph|C|', 'Quick|Harald H|HH|', 'Forsting|Michael|M|', 'Umutlu|Lale|L|', 'Schlamann|Marc|M|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002289:Carcinoma, Non-Small-Cell Lung D003287:Contrast Media D005260:Female D019788:Fluorodeoxyglucose F18 D006801:Humans D021621:Imaging, Three-Dimensional D008175:Lung Neoplasms D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D064847:Multimodal Imaging D009367:Neoplasm Staging D049268:Positron-Emission Tomography D019275:Radiopharmaceuticals D012680:Sensitivity and Specificity
staging Lung cancer 18F-FDG-PET cerebral metastases integrated PET/MRI magnetic resonance imaging (MRI)