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Imaging with 124I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT?

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

Abstract

Purpose

The aim of this study was to compare integrated PET/CT and PET/MRI for their usefulness in detecting and categorizing cervical iodine-positive lesions in patients with differentiated thyroid cancer using 124I as tracer.

Methods

The study group comprised 65 patients at high risk of iodine-positive metastasis who underwent PET/CT (low-dose CT scan, PET acquisition time 2 min; PET/CT2) followed by PET/MRI of the neck 24 h after 124I administration. PET images from both modalities were analysed for the numbers of tracer-positive lesions. Two different acquisition times were used for the comparisons, one matching the PET/CT2 acquisition time (2 min, PET/MRI2) and the other covering the whole MRI scan time (30 min, PET/MRI30). Iodine-positive lesions were categorized as metastasis, thyroid remnant or inconclusive according to their location on the PET/CT images. Morphological information provided by MRI was considered for evaluation of lesions on PET/MRI and for volume information.

Results

PET/MRI2 detected significantly more iodine-positive metastases and thyroid remnants than PET/CT2 (72 vs. 60, p = 0.002, and 100 vs. 80, p = 0.001, respectively), but the numbers of patients with at least one tumour lesion identified were not significantly different (21/65 vs. 17/65 patients). PET/MRI30 tended to detect more PET-positive metastases than PET/MRI2 (88 vs. 72), but the difference was not significant (p = 0.07). Of 21 lesions classified as inconclusive on PET/CT, 5 were assigned to metastasis or thyroid remnant when evaluated by PET/MRI. Volume information was available in 34 % of iodine-positive metastases and 2 % of thyroid remnants on PET/MRI.

Conclusions

PET/MRI of the neck was found to be superior to PET/CT in detecting iodine-positive lesions. This was attributed to the higher sensitivity of the PET component, Although helpful in some cases, we found no substantial advantage of PET/MRI over PET/CT in categorizing iodine-positive lesions as either metastasis or thyroid remnant. Volume information provided by MRI for some iodine-positive lesions might be useful in dosimetry.

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Authors and Affiliations

  1. Medical Faculty, Department of Nuclear Medicine, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany

    I. Binse, T. D. Poeppel, M. Ruhlmann, B. Gomez, A. Bockisch & S. J. Rosenbaum-Krumme

  2. Medical Faculty, Department of Radiology, University of Duisburg-Essen, Essen, Germany

    L. Umutlu

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  1. I. Binse
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  2. T. D. Poeppel
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  3. M. Ruhlmann
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  4. B. Gomez
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  5. L. Umutlu
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  6. A. Bockisch
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  7. S. J. Rosenbaum-Krumme
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Correspondence to I. Binse.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not describe any studies with animals performed by any of the authors.

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

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Binse, I., Poeppel, T.D., Ruhlmann, M. et al. Imaging with 124I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT?. Eur J Nucl Med Mol Imaging 43, 1011–1017 (2016). https://doi.org/10.1007/s00259-015-3288-y

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  • DOI: https://doi.org/10.1007/s00259-015-3288-y

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