Martin W. Huellner MD, Presenter: Nothing to Disclose

Carsten M. Pietsch MD, Abstract Co-Author: Nothing to Disclose

Lars Husmann MD, Abstract Co-Author: Nothing to Disclose

Cacilia Mader MD, Abstract Co-Author: Nothing to Disclose

Felipe De Galiza Barbosa, Abstract Co-Author: Nothing to Disclose

Gaspar Delso PhD, Abstract Co-Author: Employee, General Electric Company

Miguel Porto, Abstract Co-Author: Nothing to Disclose

Gustav K. Von Schulthess MD, PhD, Abstract Co-Author: Research Grant, General Electric Company

Patrick Veit-Haibach MD, Abstract Co-Author: Research Grant, Bayer AG Resaarch Grant, F. Hoffmann-La Roche Ltd Research Grant, General Electric Company

To compare the diagnostic accuracy of whole-body PET/MR with that of whole-body PET/CT in determining the stage of disease in non-small-cell lung cancer.

In this prospective study, sequential whole-body FDG-PET/CT-MR was performed in 40 patients (median age 65 years, range 39 to 85 years, 12 females, 28 males) with suspected or proven NSCLC. MR (LAVA, STIR, Propeller) was acquired during the acquisition time of PET (15 minutes). PET alone, PET/CT and PET/MR were evaluated separately, and a tumor-node-metastasis (TNM) stage was assigned based upon the image analysis. Nodal stations were identified according to the mapping system of the American Thoracic Society. The standard of reference was histopathology for tumor and nodal stage in 17 patients, and follow-up with imaging in 23 patients. Distant metastases were either confirmed by histopathology or by follow-up with imaging. The staging classification was rated as correct (score of 2), equivocal (score of 1), or incorrect (score of 0). Wilcoxon signed ranks test was used to compare PET/CT and PET/MR.

Eight patients were excluded because histopathology revealed SCLC or non-neoplastic lung lesions. The T/N/M staging classification by PET/MR was correct in 20 patients (63%) / 22 (69%) / 24 (75%), equivocal in 2 patients (6%) / 2 (6%) / 0 (0%), and incorrect in 10 patients (31%) / 8 (25%) / 8 (25%). The T/N/M staging classification by PET/CT was correct in 22 patients (69%) / 19 (59%) / 20 (63%), equivocal in 1 patient (3%) / 4 (13%) / 5 (16%), and incorrect in 9 patients (28%) / 9 (28%) / 7 (22%). Consistently, TNM staging was of equal accuracy with PET/MR and PET/CT (T: p = 0.633, N: p = 0.465, M: p = 0.672). Results were similar within the subgroup with histopathology as standard of reference.

Whole-body staging with PET/MR with 15 minutes acquisition time yields equal diagnostic accuracy compared with PET/CT in patients with NSCLC.

Lung cancer patients may be effectively staged with PET/MR which is not more time-consuming than PET/CT.

Huellner, M, Pietsch, C, Husmann, L, Mader, C, Barbosa, F, Delso, G, Porto, M, Von Schulthess, G, Veit-Haibach, P, Staging of NSCLC with PET/MR and PET/CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005663.html