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Evaluation of diagnostic performance of whole-body simultaneous PET/MRI in pediatric lymphoma

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Abstract

Background

Whole-body 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is the standard of care for lymphoma. Simultaneous PET/MRI (magnetic resonance imaging) is a promising new modality that combines the metabolic information of PET with superior soft-tissue resolution and functional imaging capabilities of MRI while decreasing radiation dose. There is limited information on the clinical performance of PET/MRI in the pediatric setting.

Objective

This study evaluated the feasibility, dosimetry, and qualitative and quantitative diagnostic performance of simultaneous whole-body FDG-PET/MRI in children with lymphoma compared to PET/CT.

Materials and methods

Children with lymphoma undergoing standard of care FDG-PET/CT were prospectively recruited for PET/MRI performed immediately after the PET/CT. Images were evaluated for quality, lesion detection and anatomical localization of FDG uptake. Maximum and mean standardized uptake values (SUVmax/mean) of normal organs and SUVmax of the most FDG-avid lesions were measured for PET/MRI and PET/CT. Estimation of radiation exposure was calculated using specific age-related factors.

Results

Nine PET/MRI scans were performed in eight patients (mean age: 15.3 years). The mean time interval between PET/CT and PET/MRI was 51 ± 10 min. Both the PET/CT and PET/MRI exams had good image quality and alignment with complete (9/9) concordance in response assessment. The SUVs from PET/MRI and PET/CT were highly correlated for normal organs (SUVmean r2: 0.88, P<0.0001) and very highly for FDG-avid lesions (SUVmax r2: 0.94, P=0.0002). PET/MRI demonstrated an average percent radiation exposure reduction of 39% ± 13% compared with PET/CT.

Conclusion

Simultaneous whole-body PET/MRI is clinically feasible in pediatric lymphoma. PET/MRI performance is comparable to PET/CT for lesion detection and SUV measurements. Replacement of PET/CT with PET/MRI can significantly decrease radiation dose from diagnostic imaging in children.

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Authors and Affiliations

  1. Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., St. Louis, MO, 63110, USA

    Maria Rosana Ponisio, Jonathan McConathy, Richard Laforest & Geetika Khanna

  2. Department of Radiology, University of Alabama at Birmingham, 619 19th St S, JT 772, Birmingham, AL, 35249, USA

    Jonathan McConathy

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  1. Maria Rosana Ponisio
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  2. Jonathan McConathy
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  3. Richard Laforest
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  4. Geetika Khanna
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Correspondence to Maria Rosana Ponisio.

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Conflicts of interest

Dr. J. McConathy receives consulting fees from GE Healthcare and Siemens Healthcare.

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Ponisio, M.R., McConathy, J., Laforest, R. et al. Evaluation of diagnostic performance of whole-body simultaneous PET/MRI in pediatric lymphoma. Pediatr Radiol 46, 1258–1268 (2016). https://doi.org/10.1007/s00247-016-3601-3

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  • DOI: https://doi.org/10.1007/s00247-016-3601-3

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