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Prospective comparison of 18F-FDG PET/MRI and 18F-FDG PET/CT for thoracic staging of non-small cell lung cancer

  • Julian KirchnerEmail author
  • Lino M. Sawicki
  • Felix Nensa
  • Benedikt M. Schaarschmidt
  • Henning Reis
  • Marc Ingenwerth
  • Simon Bogner
  • Clemens Aigner
  • Christian Buchbender
  • Lale Umutlu
  • Gerald Antoch
  • Ken Herrmann
  • Philipp Heusch
Original Article

Abstract

Objectives

To compare the diagnostic performance of 18F-FDG PET/MRI and 18F-FDG PET/CT for primary and locoregional lymph node staging in non-small cell lung cancer (NSCLC).

Methods

In this prospective study, a total of 84 patients (51 men, 33 women, mean age 62.5 ± 9.1 years) with histopathologically confirmed NSCLC underwent 18F-FDG PET/CT followed by 18F-FDG PET/MRI in a single injection protocol. Two readers independently assessed T and N staging in separate sessions according to the seventh edition of the American Joint Committee on Cancer staging manual for 18F-FDG PET/CT and 18F-FDG PET/MRI, respectively. Histopathology as a reference standard was available for N staging in all 84 patients and for T staging in 39 patients. Differences in staging accuracy were assessed by McNemars chi2 test. The maximum standardized uptake value (SUVmax) and longitudinal diameters of primary tumors were correlated using Pearson’s coefficients.

Results

T stage was categorized concordantly in 18F-FDG PET/MRI and 18F-FDG PET/CT in 38 of 39 (97.4%) patients. Herein, 18F-FDG PET/CT and 18F-FDG PET/MRI correctly determined the T stage in 92.3 and 89.7% of patients, respectively. N stage was categorized concordantly in 83 of 84 patients (98.8%). 18F-FDG PET/CT correctly determined the N stage in 78 of 84 patients (92.9%), while 18F-FDG PET/MRI correctly determined the N stage in 77 of 84 patients (91.7%). Differences between 18F-FDG PET/CT and 18F-FDG PET/MRI in T and N staging accuracy were not statistically significant (p > 0.5, each). Tumor size and SUVmax measurements derived from both imaging modalities exhibited excellent correlation (r = 0.963 and r = 0.901, respectively).

Conclusion

18F-FDG PET/MRI and 18F-FDG PET/CT show an equivalently high diagnostic performance for T and N staging in patients suffering from NSCLC.

Keywords

PET/MRI PET/CT NSCLC Thoracic staging 

Notes

Compliance with ethical standards

Conflict of interest

None.

Ethical approval

All procedures performed 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.

Informed consent

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

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Julian Kirchner
    • 1
    Email author
  • Lino M. Sawicki
    • 1
  • Felix Nensa
    • 2
  • Benedikt M. Schaarschmidt
    • 1
  • Henning Reis
    • 3
  • Marc Ingenwerth
    • 3
  • Simon Bogner
    • 4
  • Clemens Aigner
    • 5
  • Christian Buchbender
    • 1
  • Lale Umutlu
    • 2
  • Gerald Antoch
    • 1
  • Ken Herrmann
    • 6
  • Philipp Heusch
    • 1
  1. 1.Department of Diagnostic and Interventional RadiologyUniversity Dusseldorf, Medical FacultyDusseldorfGermany
  2. 2.Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenUniversity of Duisburg-EssenEssenGermany
  3. 3.Institute of Pathology, University Hospital Essen, West German Cancer CenterUniversity Duisburg-Essen and the German Cancer Consortium (DKTK) EssenEssenGermany
  4. 4.Department of Medical Oncology, University Hospital Essen, West German Cancer CenterUniversity of Duisburg-EssenEssenGermany
  5. 5.Department of Thoracic Surgery and Surgical Endoscopy, University Hospital Essen, RuhrlandklinikUniversity of Duisburg-EssenEssenGermany
  6. 6.Department of Nuclear Medicine, University Hospital EssenUniversity of Duisburg-EssenEssenGermany

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