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Preoperative staging of non-small cell lung cancer: prospective comparison of PET/MR and PET/CT

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Abstract

Objectives

To prospectively compare the accuracies of PET/MR and PET/CT in the preoperative staging of non-small cell lung cancer (NSCLC).

Methods

Institutional review board approval and patients’ informed consents were obtained. 45 patients with proven or radiologically suspected lung cancer which appeared to be resectable on CT were enrolled. PET/MR was performed for the preoperative staging of NSCLC followed by PET/CT without contrast enhancement on the same day. Dedicated MR images including diffusion weighted images were obtained. Readers assessed PET/MR and PET/CT with contrast-enhanced CT. Accuracies of PET/MR and PET/CT for NSCLC staging were compared.

Results

Primary tumour stages (n = 40) were correctly diagnosed in 32 patients (80.0 %) on PET/MR and in 32 patients (80.0 %) on PET/CT (P = 1.0). Node stages (n = 42) were correctly determined in 24 patients (57.1 %) on PET/MR and in 22 patients (52.4 %) on PET/CT (P = 0.683). Metastatic lesions in the brain, bone, liver, and pleura were detected in 6 patients (13.3 %). PET/MR missed one patient with pleural metastasis while PET/CT missed one patient with solitary brain metastasis and two patients with pleural metastases (P = 0.480).

Conclusions

This study demonstrated that PET/MR in combination with contrast-enhanced CT was comparable to PET/CT in the preoperative staging of NSCLC while reducing radiation exposure.

Key points

• PET/MR can be comparable to PET/CT for preoperative NSCLC staging.

• PET/MR and PET/CT show excellent correlation in measuring SUVmax of primary lesions.

• Using PET/MR, estimated radiation dose can decrease by 31.1 % compared with PET/CT.

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Abbreviations

NSCLC:

Non-small cell lung cancer

FDG:

18F-fluorodeoxyglucose

PET/CT:

Positron emission tomography/computed tomography

PET/MR:

Positron emission tomography/magnetic resonance

VIBE:

Volume-interpolated breath-hold examination

HASTE:

Half-Fourier acquisition single-shot turbo spin-echo

SPAIR:

Spectral selection-attenuated inversion recovery

DWI:

Diffusion-weighted imaging

ADC:

Apparent diffusion coefficient

TNM:

Tumour, node, and metastasis

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Acknowledgments

The scientific guarantor of this publication is Prof. Jin Mo Goo. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by grant from the Guerbet Korea Research Fund. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study.

Methodology: prospective, diagnostic or prognostic study, performed at one institution.

Author information

Author notes

  1. Sang Min Lee

    Present address: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Sang Min Lee, Jin Mo Goo, Chang Min Park & Soon Ho Yoon

  2. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    Sang Min Lee, Jin Mo Goo, Chang Min Park & Soon Ho Yoon

  3. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Jin Mo Goo, Chang Min Park & Young Tae Kim

  4. Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea

    Jin Chul Paeng & Gi Jeong Cheon

  5. Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea

    Young Tae Kim

  6. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

    Young Sik Park

  7. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Young Sik Park

Authors
  1. Sang Min Lee
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  2. Jin Mo Goo
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  3. Chang Min Park
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  4. Soon Ho Yoon
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Corresponding author

Correspondence to Jin Mo Goo.

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Lee, S.M., Goo, J.M., Park, C.M. et al. Preoperative staging of non-small cell lung cancer: prospective comparison of PET/MR and PET/CT. Eur Radiol 26, 3850–3857 (2016). https://doi.org/10.1007/s00330-016-4255-0

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  • DOI: https://doi.org/10.1007/s00330-016-4255-0

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