Karsten J. Beiderwellen MD, Presenter: Nothing to Disclose

Johannes Grueneisen, Abstract Co-Author: Nothing to Disclose

Verena Hartung, Abstract Co-Author: Nothing to Disclose

Philipp Heusch MD, Abstract Co-Author: Nothing to Disclose

Rainer Kimmig, Abstract Co-Author: Nothing to Disclose

Thomas C. Lauenstein MD, Abstract Co-Author: Nothing to Disclose

Lale Umutlu MD, Abstract Co-Author: Consultant, Bayer AG

To evaluate the diagnostic benefit of integrated 18F-FDG PET/MRI for whole-body staging of female patients with recurrent pelvic malignancies compared to MRI alone.

13 patients with suspected recurrence of cervical or ovarian cancer underwent whole body 18F-FDG PET/MRI (Biograph mMR, Siemens, Erlangen, Germany). The MR protocol included 1) T1 2D FLASH pre and post contrast, 2) T2 HASTE and 3) DWI. Two readers evaluated the following datasets subsequently (1) 18F-FDG PET/MRI, (2) whole-body MRI and (3) whole-body MRI + DWI. Two readers evaluated the datasets separately for the following features using a 4-point ordinal scale (1) lesion conspicuity, (2) lesion count, (3) lesion dignity (benign/malignant/indeterminate), (4) diagnostic confidence (3-point ordinal scale). Wilcoxon ́s signed-rank test was applied to assess statistical significance.  

In 10 of 13 patients malignant lesions were present. A total of 41 lesions, comprising 29 malignant and 12 benign lesions were detected. PET/MRI offered correct and respectively superior identification of all 10 patients with cancer lesions, compared to MRI (without DWI, 6/10; including DWI 8/10). Additionally, 18F-FDG PET/MRI exhibited higher conspicuity (PET/MRI: median: 4, range: 3-4; MRI: median: 4, range 1-4; MRI + DWI: median: 4, range 2-4) and diagnostic confidence (PET/MRI: median: 3, range 2-3; MRI: median: 2, range 1-3, MRI +DWI: median: 3, range 1-3) in the detection of malignant lesions (p<0.05). There was no significant difference in the detection of benign lesions.

Our results demonstrate the superiority of 18F-FDG PET/MRI in detecting malignant lesions compared to MRI alone. Thus, whole body PET/MRI may be utilized as a stand-alone imaging technique for staging of patients with suspected pelvic malignancies, allowing for significant time reduction due to omission of T2w and DWI MRI.

Whole-body 18F-FDG PET/MRI may be applied as a stand-alone staging technique for patients with suspected pelvic malignancies.

Beiderwellen, K, Grueneisen, J, Hartung, V, Heusch, P, Kimmig, R, Lauenstein, T, Umutlu, L, 18F-FDG PET/MRI versus MRI Alone for Whole Body Staging of Patients with Recurrent Malignancies of the Female Pelvis.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13026835.html