1. Performing clinical 18F-FDG-PET/MRI of the mediastinum optimising a dedicated, patient-friendly protocol
- Author
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Felix M. Mottaghy, Maaike Berbee, Jurgen Peerlings, Frans C. H. Bakers, Philippe Lambin, Joachim E. Wildberger, Stefan Vöö, Leonie Paulis, Roel Wierts, Aswin L. Hoffmann, Cristina Mitea, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Promovendi ODB, Radiotherapie, MUMC+: DA BV Klinisch Fysicus (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Nucleaire Geneesk (9), MUMC+: DA BV Medisch Specialisten Radiologie (9), MUMC+: MA Radiotherapie OC (9), RS: CARIM - R3.11 - Imaging, MUMC+: DA Beeldvorming (5), Precision Medicine, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, and RS: Carim - B06 Imaging
- Subjects
Adult ,Male ,oesophageal cancer ,MOTION ,PET/CT ,CELL LUNG-CANCER ,ESOPHAGEAL CANCER ,PET-CT ,Computed tomography ,Mediastinal Neoplasms ,Multimodal Imaging ,030218 nuclear medicine & medical imaging ,18f fdg pet ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,hybrid imaging ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,Protocol (science) ,INTERNATIONAL WORKSHOP ,medicine.diagnostic_test ,business.industry ,ECHO-SEQUENCE ,Mediastinum ,General Medicine ,Middle Aged ,Magnetic Resonance Imaging ,mediastinum ,COMBINED PET/MRI ,medicine.anatomical_structure ,non-small-cell lung cancer ,PRACTICE GUIDELINES ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,PET-MRI ,Female ,Non small cell ,Nuclear medicine ,business ,RADIAL VIBE ,MRI - Abstract
Objective To construct a mediastinal-specific fluorine-18-fluorodeoxyglucose (F-18-FDG)-PET/MR protocol with high-quality MRI of minimal acquisition-time and comparable diagnostic value to F-18-FDG-PET/computed tomography (CT).Materials and methods Fifteen healthy participants received PET/MRI and 10 patients with mediastinal tumours (eight non-small-cell lung, two oesophageal cancer) received F-18-FDG-PET/MRI immediately after F-18-FDG-PET/CT. Sequences volume interpolated breath-hold examination (T1-VIBE) and Half-Fourier acquisition single-shot turbo spin echo (T2-HASTE) were optimised by varying the parameters: breath-hold (BH, end-expiration), fat suppression (spectral adiabatic inversion recovery), and ECG-triggering (ECG, end-diastole). Image quality (IQ) of each sequence-variation was qualitatively scored by medical experts and quantitatively assessed by calculating signal-to-noise ratios, contrast relative to muscle, standardized-uptake-value, and tumour-to-blood ratios. Patient comfort was evaluated on patients' experience. Diagnostic accuracy of F-18-FDG-PET/MRI was compared to F-18-FDG-PET/CT, in reference to histopathology/cytopathology.Results ECG-triggered T1-VIBE images showed the highest signal-to-noise ratio (P 0.9). Qualitative IQ of T1-VIBE and T2-HASTE declined after spectral adiabatic inversion recovery fat-suppression. All patients could maintain BH at end-expiration and reported no discomfort. Diagnostic performance of F-18-FDG-PET/MR was not significantly different from F-18-FDG-PET/CT with comparable staging, standardized-uptake-values, and tumour-to-blood ratios. However, T-status was more often over-staged on F-18-FDG-PET/CT, while N-status was more frequently under-staged on F-18-FDG-PET/MR.Conclusion ECG-triggered T1-VIBE sequences acquired during short, multiple BHs are recommended for mediastinal imaging using F-18-FDG-PET/MR. With dedicated protocols, F-18-FDG-PET/MRI will be useful in thoracic oncology and aid in diagnostic evaluation and tailored treatment decision-making. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.
- Published
- 2019