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Detection of liver metastases in patients with adenocarcinomas of the gastrointestinal tract: comparison of 18F-FDG PET/CT and MR imaging

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Abstract

Purpose

Aim of our study was to compare the diagnostic performance of 18F-FDG PET/CT and MR imaging (MRI) in the detection of liver metastases in patients with adenocarcinomas of the gastrointestinal tract.

Methods

A total of 49 patients with adenocarcinomas of the gastrointestinal tract who had undergone 18F-FDG PET/CT and MRI of the liver were included in this study. The MRI protocol included diffusion-weighted imaging and dynamic contrast-enhanced MR imaging after intravenous injection of Gd-DTPA. PET and MR images were analyzed by two experienced radiologists. Imaging results were correlated with histopathological findings or imaging follow-up as available. Sensitivities of both modalities were compared using McNemar Test. Receiver operating characteristic (ROC) curves were calculated to determine the diagnostic performance in correctly identifying liver metastases.

Results

A total of 151 metastases were confirmed. For lesion detection, MRI was significantly superior to 18F-FDG PET/CT. Sensitivity of MRI in detecting metastases was 86.8% for Reader 1 (R1) and 87.4% for Reader 2 (R2), of PET/CT 66.2% for R1 and 68.2% for R2. Regarding only metastases with diameters of 10 mm or less, sensitivities of MRI were 66.7% for R1 and 75.0% for R2, and were significantly higher than those of PET/CT (17.9% for R1 and 20.5% for R2). ROC analysis showed superiority for lesion classification of MRI as compared to 18F-FDG PET/CT.

Conclusion

MRI is significantly superior to 18F-FDG PET/CT in the detection and classification of liver metastases in patients with adenocarcinomas of the gastrointestinal tract, especially in the detection of small metastases.

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Authors and Affiliations

  1. Department of Radiology, Klinikum Rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Christian Maegerlein, Alexander A. Fingerle, Ernst J. Rummeny & Konstantin Holzapfel

  2. Department of Nuclear Medicine, Klinikum Rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Michael Souvatzoglou

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  1. Christian Maegerlein
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Correspondence to Christian Maegerlein.

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Maegerlein, C., Fingerle, A.A., Souvatzoglou, M. et al. Detection of liver metastases in patients with adenocarcinomas of the gastrointestinal tract: comparison of 18F-FDG PET/CT and MR imaging. Abdom Imaging 40, 1213–1222 (2015). https://doi.org/10.1007/s00261-014-0283-x

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