Yoshiharu Ohno MD, PhD, Presenter: Research Grant, Toshiba Corporation Research Grant, Koninklijke Philips NV Research Grant, Bayer AG Research Grant, DAIICHI SANKYO Group Research Grant, Eisai Co, Ltd Research Grant, Terumo Corporation Research Grant, Fuji Yakuhin Co, Ltd Research Grant, FUJIFILM Holdings Corporation Research Grant, Guerbet SA

Shinichiro Seki, Abstract Co-Author: Nothing to Disclose

Mizuho Nishio MD, PhD, Abstract Co-Author: Research Grant, Toshiba Corporation

Hisanobu Koyama MD, PhD, Abstract Co-Author: Nothing to Disclose

Kota Aoyagi, Abstract Co-Author: Employee, Toshiba Corporation

Hitoshi Yamagata PhD, Abstract Co-Author: Employee, Toshiba Corporation

Takeshi Yoshikawa MD, Abstract Co-Author: Research Grant, Toshiba Corporation

Sumiaki Matsumoto MD, PhD, Abstract Co-Author: Research Grant, Toshiba Corporation

Kazuhiro Kubo RT, Abstract Co-Author: Nothing to Disclose

Kazuro Sugimura MD, PhD, Abstract Co-Author: Research Grant, Toshiba Corporation Research Grant, Koninklijke Philips NV Research Grant, Bayer AG Research Grant, Eisai Co, Ltd Research Grant, DAIICHI SANKYO Group

To determine the utility of MR signal intensity assessment on whole-body FDG-PET/MRI for improving clinical stage assessment in non-small cell lung cancer (NSCLC) patients as compared with whole-body FDG-PET/CT with contrast-enhanced (CE-) brain MRI.

140 consecutive pathologically diagnosed NSCLC patients (75 men, 65 women; mean age 72 years) prospectively underwent whole-body MRI at 3T system, integrated PET/CT, and conventional radiological examination as well as surgical, pathological and/ or follow-up examinations. Final diagnoses of T,N and M factors and clinical stage in each patient were determined according to all examination results. All co-registered PET/MRIs were generated by means of our proprietary software, and evaluated with following two methods: 1) PET/MRI evaluated by not only anatomical and metabolic information, but also MR signal intensity assessment (PET/MRI type A) and 2) PET/MRI assessed by anatomical and metabolic information (PET/MRI type B). Then, every factor and clinical stage were visually assessed on both PET/MRIs and PET/CT with CE-brain MRI. Kappa statistics were used to determine agreements for assessment of all factors and clinical stage with final diagnoses, and McNemar’s test was used to compare the diagnostic accuracy of all methods.

On PET/MRI type A, agreements of every factor and clinical stage with final diagnoses were determined as almost perfect (0.85<κ<0.94). On the other hand, agreements of every factor and clinical stage on PET/MRI type B and PET/CT with final diagnoses were determined as substantial (others: 0.60<κ<0.69) except T factor (κ=0.89) . Diagnostic accuracies of N and M factors and clinical stage on PET/MRI type A (N: 91.4 [128/140] %, M: 98.6 [138/140] %, clinical stage: 91.4 [128/140] %) were significantly higher than those on PET/MRI type B and PET/CT (N: 80.7 [113/140] %, p=0.0003; M: 90.7 [127/140] %, p=0.003; clinical stage: 80.0 [112/140] %, p=0.0002).

When MR signal intensity is evaluated as well as anatomical and metabolic information, PET/MRI can more accurately assess N and M factors and clinical stage than PET/CT with CE-brain MRI in NSCLC patients.

When MR signal intensity is assessed as well as anatomical and metabolic information, PET/MRI can more accurately evaluate clinical stage than PET/CT in NSCLC patients.

Ohno, Y, Seki, S, Nishio, M, Koyama, H, Aoyagi, K, Yamagata, H, Yoshikawa, T, Matsumoto, S, Kubo, K, Sugimura, K, Whole-Body FDG-PET/MRI: How to Improve the Accuracy of Clinical Stage Assessment as Compared with Whole-body FDG-PET/CT with CE-Brain MRI in Patients with Non-Small Cell Lung Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003774.html