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Erschienen in: European Radiology 11/2013

01.11.2013 | Oncology

N staging of lung cancer patients with PET/MRI using a three-segment model attenuation correction algorithm: Initial experience

verfasst von: A. A. Kohan, J. A. Kolthammer, J. L. Vercher-Conejero, C. Rubbert, S. Partovi, R. Jones, K. A. Herrmann, P. Faulhaber

Erschienen in: European Radiology | Ausgabe 11/2013

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Abstract

Objectives

Evaluate the performance of PET/MRI at tissue interfaces with different attenuation values for detecting lymph node (LN) metastases and for accurately measuring maximum standardised uptake values (SUVmax) in lung cancer patients.

Materials and Method

Eleven patients underwent PET/CT and PET/MRI for staging, restaging or follow-up of suspected or known lung cancer. Four experienced readers determined the N stage of the patients for each imaging method in a randomised blinded way. Concerning metastases, SUVmax of FDG-avid LNs were measured in PET/CT and PET/MRI in all patients. A standard of reference was created with a fifth experienced independent reader in combination with a chart review. Results were analysed to determine interobserver agreement, SUVmax correlation between CT and MRI (three-segment model) attenuation correction and diagnostic performance of the two techniques.

Results

Overall interobserver agreement was high (κ = 0.86) for PET/CT and substantial (κ = 0.70) for PET/MRI. SUVmax showed strong positive correlation (Spearman’s correlation coefficient = 0.93, P < 0.001) between the two techniques. Diagnostic performance of PET/MRI was slightly inferior to that of PET/CT, without statistical significance (P > 0.05).

Conclusions

PET/MRI using three-segment model attenuation correction for LN staging in lung cancer shows a strong parallel to PET/CT in terms of SUVmax, interobserver agreement and diagnostic performance.

Key Points

F18-FDG PET/MRI shows similar performance to F18-FDG PET/CT in lung cancer N staging.
PET/MRI has substantial interobserver agreement in N staging.
A three-segment model attenuation correction is reliable for assessing the mediastinum.
Literatur
1.
Zurück zum Zitat De Leyn P, Lardinois D, Van Schil PE et al (2007) ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg Off J Eur Assoc Cardiothorac Surg 32:1–8CrossRef De Leyn P, Lardinois D, Van Schil PE et al (2007) ESTS guidelines for preoperative lymph node staging for non-small cell lung cancer. Eur J Cardiothorac Surg Off J Eur Assoc Cardiothorac Surg 32:1–8CrossRef
2.
Zurück zum Zitat Sivrikoz CM, Ak I, Simsek FS, Doner E, Dundar E (2012) Is mediastinoscopy still the gold standard to evaluate mediastinal lymph nodes in patients with non-small cell lung carcinoma? Thorac Cardiovasc Surg 60:116–121PubMedCrossRef Sivrikoz CM, Ak I, Simsek FS, Doner E, Dundar E (2012) Is mediastinoscopy still the gold standard to evaluate mediastinal lymph nodes in patients with non-small cell lung carcinoma? Thorac Cardiovasc Surg 60:116–121PubMedCrossRef
3.
Zurück zum Zitat Schwenzer NF, Schraml C, Muller M et al (2012) Pulmonary lesion assessment: comparison of whole-body hybrid MR/PET and PET/CT imaging–pilot study. Radiology 264:551–558PubMedCrossRef Schwenzer NF, Schraml C, Muller M et al (2012) Pulmonary lesion assessment: comparison of whole-body hybrid MR/PET and PET/CT imaging–pilot study. Radiology 264:551–558PubMedCrossRef
4.
Zurück zum Zitat Surti S, Kuhn A, Werner ME, Perkins AE, Kolthammer J, Karp JS (2007) Performance of Philips Gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities. J Nucl Med Off Publ Soc Nucl Med 48:471–480 Surti S, Kuhn A, Werner ME, Perkins AE, Kolthammer J, Karp JS (2007) Performance of Philips Gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities. J Nucl Med Off Publ Soc Nucl Med 48:471–480
5.
Zurück zum Zitat Zaidi H, Ojha N, Morich M et al (2011) Design and performance evaluation of a whole-body Ingenuity TF PET-MRI system. Phys Med Biol 56:3091–3106PubMedCrossRef Zaidi H, Ojha N, Morich M et al (2011) Design and performance evaluation of a whole-body Ingenuity TF PET-MRI system. Phys Med Biol 56:3091–3106PubMedCrossRef
6.
Zurück zum Zitat Schulz V, Torres-Espallardo I, Renisch S et al (2011) Automatic, three-segment, MR-based attenuation correction for whole-body PET/MR data. Eur J Nucl Med Mol Imaging 38:138–152PubMedCrossRef Schulz V, Torres-Espallardo I, Renisch S et al (2011) Automatic, three-segment, MR-based attenuation correction for whole-body PET/MR data. Eur J Nucl Med Mol Imaging 38:138–152PubMedCrossRef
7.
Zurück zum Zitat Tsim S, O'Dowd CA, Milroy R, Davidson S (2010) Staging of non-small cell lung cancer (NSCLC): a review. Respir Med 104:1767–1774PubMedCrossRef Tsim S, O'Dowd CA, Milroy R, Davidson S (2010) Staging of non-small cell lung cancer (NSCLC): a review. Respir Med 104:1767–1774PubMedCrossRef
8.
Zurück zum Zitat Viera AJ, Garrett JM (2005) Understanding interobserver agreement: the kappa statistic. Fam Med 37:360–363PubMed Viera AJ, Garrett JM (2005) Understanding interobserver agreement: the kappa statistic. Fam Med 37:360–363PubMed
9.
Zurück zum Zitat Zou KH, Tuncali K, Silverman SG (2003) Correlation and simple linear regression. Radiology 227:617–622PubMedCrossRef Zou KH, Tuncali K, Silverman SG (2003) Correlation and simple linear regression. Radiology 227:617–622PubMedCrossRef
10.
Zurück zum Zitat Li X, Zhang H, Xing L et al (2012) Mediastinal lymph nodes staging by 18F-FDG PET/CT for early stage non-small cell lung cancer: a multicenter study. Radiother Oncol J Eur Soc Ther Radiol Oncol 102:246–250CrossRef Li X, Zhang H, Xing L et al (2012) Mediastinal lymph nodes staging by 18F-FDG PET/CT for early stage non-small cell lung cancer: a multicenter study. Radiother Oncol J Eur Soc Ther Radiol Oncol 102:246–250CrossRef
11.
Zurück zum Zitat Bini J, Izquierdo-Garcia D, Mateo J et al (2013) Preclinical evaluation of MR attenuation correction versus CT attenuation correction on a sequential whole-body MR/PET scanner. Investig Radiol. doi:10.1097/RLI.0b013e31827a49ba Bini J, Izquierdo-Garcia D, Mateo J et al (2013) Preclinical evaluation of MR attenuation correction versus CT attenuation correction on a sequential whole-body MR/PET scanner. Investig Radiol. doi:10.​1097/​RLI.​0b013e31827a49ba​
12.
Zurück zum Zitat Heusch P, Buchbender C, Beiderwellen K et al (2013) Standardized uptake values for [(18)F] FDG in normal organ tissues: Comparison of whole-body PET/CT and PET/MRI. Eur J Radiol. doi:10.1016/j.ejrad.2013.01.008 Heusch P, Buchbender C, Beiderwellen K et al (2013) Standardized uptake values for [(18)F] FDG in normal organ tissues: Comparison of whole-body PET/CT and PET/MRI. Eur J Radiol. doi:10.​1016/​j.​ejrad.​2013.​01.​008
13.
Zurück zum Zitat Kim JH, Lee JS, Song IC, Lee DS (2012) Comparison of segmentation-based attenuation correction methods for PET/MRI: evaluation of bone and liver standardized uptake value with oncologic PET/CT data. J Nucl Med Off Publ Soc Nucl Med 53:1878–1882 Kim JH, Lee JS, Song IC, Lee DS (2012) Comparison of segmentation-based attenuation correction methods for PET/MRI: evaluation of bone and liver standardized uptake value with oncologic PET/CT data. J Nucl Med Off Publ Soc Nucl Med 53:1878–1882
14.
Zurück zum Zitat Schramm G, Langner J, Hofheinz F et al (2013) Quantitative accuracy of attenuation correction in the Philips Ingenuity TF whole-body PET/MR system: a direct comparison with transmission-based attenuation correction. Magma 26:115–126PubMedCrossRef Schramm G, Langner J, Hofheinz F et al (2013) Quantitative accuracy of attenuation correction in the Philips Ingenuity TF whole-body PET/MR system: a direct comparison with transmission-based attenuation correction. Magma 26:115–126PubMedCrossRef
15.
Zurück zum Zitat Wiesmuller M, Quick HH, Navalpakkam B et al (2013) Comparison of lesion detection and quantitation of tracer uptake between PET from a simultaneously acquiring whole-body PET/MR hybrid scanner and PET from PET/CT. Eur J Nucl Med Mol Imaging 40:12–21PubMedCrossRef Wiesmuller M, Quick HH, Navalpakkam B et al (2013) Comparison of lesion detection and quantitation of tracer uptake between PET from a simultaneously acquiring whole-body PET/MR hybrid scanner and PET from PET/CT. Eur J Nucl Med Mol Imaging 40:12–21PubMedCrossRef
16.
Zurück zum Zitat Delbeke D, Coleman RE, Guiberteau MJ et al (2006) Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med Off Publ Soc Nucl Med 47:885–895 Delbeke D, Coleman RE, Guiberteau MJ et al (2006) Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med Off Publ Soc Nucl Med 47:885–895
17.
Zurück zum Zitat Nakayama J, Miyasaka K, Omatsu T et al (2010) Metastases in mediastinal and hilar lymph nodes in patients with non-small cell lung cancer: quantitative assessment with diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient. J Comput Assist Tomogr 34:1–8PubMedCrossRef Nakayama J, Miyasaka K, Omatsu T et al (2010) Metastases in mediastinal and hilar lymph nodes in patients with non-small cell lung cancer: quantitative assessment with diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient. J Comput Assist Tomogr 34:1–8PubMedCrossRef
18.
Zurück zum Zitat Nomori H, Mori T, Ikeda K et al (2008) Diffusion-weighted magnetic resonance imaging can be used in place of positron emission tomography for N staging of non-small cell lung cancer with fewer false-positive results. J Thorac Cardiovasc Surg 135:816–822PubMedCrossRef Nomori H, Mori T, Ikeda K et al (2008) Diffusion-weighted magnetic resonance imaging can be used in place of positron emission tomography for N staging of non-small cell lung cancer with fewer false-positive results. J Thorac Cardiovasc Surg 135:816–822PubMedCrossRef
19.
Zurück zum Zitat Ohno Y, Koyama H, Nogami M et al (2007) STIR turbo SE MR imaging vs. coregistered FDG-PET/CT: quantitative and qualitative assessment of N-stage in non-small-cell lung cancer patients. J Magn Reson Imaging JMRI 26:1071–1080CrossRef Ohno Y, Koyama H, Nogami M et al (2007) STIR turbo SE MR imaging vs. coregistered FDG-PET/CT: quantitative and qualitative assessment of N-stage in non-small-cell lung cancer patients. J Magn Reson Imaging JMRI 26:1071–1080CrossRef
20.
Zurück zum Zitat Ohno Y, Koyama H, Yoshikawa T et al (2011) N stage disease in patients with non-small cell lung cancer: efficacy of quantitative and qualitative assessment with STIR turbo spin-echo imaging, diffusion-weighted MR imaging, and fluorodeoxyglucose PET/CT. Radiology 261:605–615PubMedCrossRef Ohno Y, Koyama H, Yoshikawa T et al (2011) N stage disease in patients with non-small cell lung cancer: efficacy of quantitative and qualitative assessment with STIR turbo spin-echo imaging, diffusion-weighted MR imaging, and fluorodeoxyglucose PET/CT. Radiology 261:605–615PubMedCrossRef
21.
Zurück zum Zitat Huang B, Law MW, Khong PL (2009) Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. Radiology 251:166–174PubMedCrossRef Huang B, Law MW, Khong PL (2009) Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. Radiology 251:166–174PubMedCrossRef
Metadaten
Titel
N staging of lung cancer patients with PET/MRI using a three-segment model attenuation correction algorithm: Initial experience
verfasst von
A. A. Kohan
J. A. Kolthammer
J. L. Vercher-Conejero
C. Rubbert
S. Partovi
R. Jones
K. A. Herrmann
P. Faulhaber
Publikationsdatum
01.11.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 11/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2914-y

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