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[18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic potential of PET/MRI with [18F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated.

Methods

The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [18F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [18F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference.

Results

Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [18F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions.

Conclusion

In patients with thyroid cancer and suspected or known dedifferentiation, [18F]FDG PET/MRI was inferior to low-dose [18F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [18F]FDG PET/MRI was equal to contrast-enhanced neck [18F]FDG PET/CT. Therefore, [18F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast agent is contraindicated.

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Acknowledgements

We are grateful to the imaging staff of both our departments in particular Mrs. Anne Kanzog and Mr. Stan Milachowski. Furthermore, we are thankful to Mrs. Lale Umutlu (University Hospital Essen) for sharing her expertise in PET/MRI when asked.

Compliance with ethical standards

ᅟ

Conflict of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany

    Alexis Vrachimis, Christian Wenning, Matthias Weckesser, Michael Schäfers & Lars Stegger

  2. Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany

    Matthias Christian Burg & Thomas Allkemper

  3. European Institute for Molecular Imaging, Westfälische Wilhelms University Münster, Waldeyerstrasse 15, 48149, Münster, Germany

    Michael Schäfers

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  1. Alexis Vrachimis
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  2. Matthias Christian Burg
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  3. Christian Wenning
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Correspondence to Alexis Vrachimis.

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Vrachimis, A., Burg, M.C., Wenning, C. et al. [18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 43, 212–220 (2016). https://doi.org/10.1007/s00259-015-3195-2

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  • DOI: https://doi.org/10.1007/s00259-015-3195-2

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