18 F-FDG-PET / MR increases diagnostic confidence in detection of bone metastases compared with 18 F-FDG-PET / CT

PURPOSE: The aim of this study was to compare detection, lesion conspicuity and reader confidence of F-fluorodeoxyglucose (F-FDG)-PET/MR and F-FDG-PET/computed tomography (CT) in patients with F-FDG avid bone metastases. MATERIALS AND METHODS: In this prospective study, a total of 30 PET/CT and PET/MRI data sets were performed in 24 patients. Each examination was evaluated for the presence of PET-positive bone lesions consistent with metastatic involvement. Conspicuity of PET-positive bone lesions was evaluated on the corresponding PET/CT and PET/MR images and compared using the Wilcoxon signed-ranks test. Reader confidence was determined to evaluate whether PET/CT or PET/MR was more useful for the assessment of the bone metastases and was compared using Student’s t-test. RESULTS: Overall, in both examinations, PET/CT and PET/MRI detected 86 F-FDG-positive bone lesions. On all 30 PET/MRI examinations, at least one morphological correlate for F-FDG-positive bone lesions was found on the MR component (82 out of 86 lesions). PET/CT imaging allowed identification of corresponding structural changes on the CT component in 23 out of 30 studies (65 out of 86 lesions). In lesion-by-lesion analysis, the mean lesion conspicuity was significantly better on T1 fat MR imaging compared with CT imaging (P=0.005). In seven out of 30 studies, a significant increase in reader confidence of PET/MRI compared with PET/CT was found. CONCLUSION: PET/MRI offers higher reader confidence and improved conspicuity in bone metastases compared with PET/CT. However, the overall detection rate was not different. The highest possible clinical impact of PET/MRI appears to be in patients with limited, early bone metastatic disease. DOI: https://doi.org/10.1097/MNM.0000000000000387 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-113245 Published Version Originally published at: Samarin, Andrei; Hüllner, Martin; Queiroz, Marcelo A; Stolzmann, Paul; Burger, Irene A; von Schulthess, Gustav; Veit-Haibach, Patrick (2015). 18F-FDG-PET/MR increases diagnostic confidence in detection of bone metastases compared with 18F-FDG-PET/CT. Nuclear medicine communications, 36(12):11651173. DOI: https://doi.org/10.1097/MNM.0000000000000387 F-FDG-PET/MR increases diagnostic confidence in detection of bone metastases compared with F-FDG-PET/CT Andrei Samarin, Martin Hüllner, Marcelo A. Queiroz, Paul Stolzmann, Irene A. Burger, Gustav von Schulthess and Patrick Veit-Haibach Purpose The aim of this study was to compare detection, lesion conspicuity and reader confidence of F-fluorodeoxyglucose (F-FDG)-PET/MR and F-FDGPET/computed tomography (CT) in patients with F-FDG avid bone metastases. Materials and methods In this prospective study, a total of 30 PET/CT and PET/MRI data sets were performed in 24 patients. Each examination was evaluated for the presence of PET-positive bone lesions consistent with metastatic involvement. Conspicuity of PET-positive bone lesions was evaluated on the corresponding PET/CT and PET/MR images and compared using the Wilcoxon signed-ranks test. Reader confidence was determined to evaluate whether PET/CT or PET/MR was more useful for the assessment of the bone metastases and was compared using Student’s t-test. Results Overall, in both examinations, PET/CT and PET/ MRI detected 86 F-FDG-positive bone lesions. On all 30 PET/MRI examinations, at least one morphological correlate for F-FDG-positive bone lesions was found on the MR component (82 out of 86 lesions). PET/CT imaging allowed identification of corresponding structural changes on the CT component in 23 out of 30 studies (65 out of 86 lesions). In lesion-by-lesion analysis, the mean lesion conspicuity was significantly better on T1 fat MR imaging compared with CT imaging (P= 0.005). In seven out of 30 studies, a significant increase in reader confidence of PET/MRI compared with PET/CT was found. Conclusion PET/MRI offers higher reader confidence and improved conspicuity in bone metastases compared with PET/CT. However, the overall detection rate was not different. The highest possible clinical impact of PET/MRI appears to be in patients with limited, early bone metastatic disease. Nucl Med Commun 00:000–000 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Nuclear Medicine Communications 2015, 00:000–000