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European Journal of Nuclear Medicine and Molecular Imaging

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01.11.2012 | Original Article

Diagnostic value of combined ¹⁸F-FDG PET/MRI for staging and restaging in paediatric oncology

verfasst von: Thomas Pfluger, Henriette I. Melzer, Wolfgang P. Mueller, Eva Coppenrath, Peter Bartenstein, Michael H. Albert, Irene Schmid

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2012

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Abstract

Purpose

The present study compares the diagnostic value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and MRI to combined/registered ¹⁸F-FDG PET/MRI for staging and restaging in paediatric oncology.

Methods

Over 8 years and 2 months, 270 ¹⁸F-FDG PET and 270 MRI examinations (mean interval 5 days) were performed in 132 patients with proven (n = 117) or suspected (n = 15) malignant disease: solid tumours (n = 64), systemic malignancy (n = 53) and benign disease (n = 15). A total of 259 suspected tumour lesions were analysed retrospectively during primary diagnosis and 554 lesions during follow-up. Image analysis was performed separately on each modality, followed by analysis of combined and registered ¹⁸F-FDG PET/MRI imaging.

Results

A total of 813 lesions were evaluated and confirmed by histopathology (n = 158) and/or imaging follow-up (n = 655) after 6 months. In the separate analysis of ¹⁸F-FDG PET and MRI, sensitivity was 86 %/94 % and specificity 85 %/38 %. Combined/registered ¹⁸F-FDG PET/MRI led to a sensitivity of 97 %/97 % and specificity of 81 %/82 %. False-positive results (¹⁸F-FDG PET n = 69, MRI n = 281, combined ¹⁸F-FDG PET/MRI n = 85, registered ¹⁸F-FDG PET/MRI n = 80) were due to physiological uptake or post-therapeutic changes. False-negative results (¹⁸F-FDG PET n = 50, MRI n = 20, combined ¹⁸F-FDG PET/MRI n = 11, registered ¹⁸F-FDG PET/MRI n = 11) were based on low uptake or minimal morphological changes. Examination-based evaluation during follow-up showed a sensitivity/specificity of 91 %/81 % for ¹⁸F-FDG PET, 93 %/30 % for MRI and 96 %/72 % for combined ¹⁸F-FDG PET/MRI.

Conclusion

For the detection of single tumour lesions, registered ¹⁸F-FDG PET/MRI proved to be the methodology of choice for adequate tumour staging. In the examination-based evaluation, MRI alone performed better than ¹⁸F-FDG PET and combined/registered imaging during primary diagnosis. At follow-up, however, the examination-based evaluation demonstrated a superiority of ¹⁸F-FDG PET alone.

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Titel: Diagnostic value of combined 18F-FDG PET/MRI for staging and restaging in paediatric oncology
verfasst von: Thomas Pfluger
Henriette I. Melzer
Wolfgang P. Mueller
Eva Coppenrath
Peter Bartenstein
Michael H. Albert
Irene Schmid
Publikationsdatum: 01.11.2012
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2012
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-012-2228-3

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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