European Radiology

, Volume 24, Issue 8, pp 2023–2030 | Cite as

Whole-body [18F]FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results

  • Karsten Beiderwellen
  • Michael Huebner
  • Philipp Heusch
  • Johannes Grueneisen
  • Verena Ruhlmann
  • Felix Nensa
  • Hilmar Kuehl
  • Lale Umutlu
  • Sandra Rosenbaum-Krumme
  • Thomas C. Lauenstein
Molecular Imaging



To compare [18 F]FDG PET/MRI with PET/CT for the assessment of bone lesions in oncologic patients.


This prospective study included 67 patients with solid tumours scheduled for PET/CT with [18 F]FDG who also underwent a whole-body PET/MRI scan. The datasets (PET/CT, PET/MRI) were rated by two readers regarding lesion conspicuity (four-point scale) and diagnostic confidence (five-point scale). Median scores were compared using the Wilcoxon test.


Bone metastases were present in ten patients (15 %), and benign bone lesions in 15 patients (22 %). Bone metastases were predominantly localized in the pelvis (18 lesions, 38 %) and the spine (14 lesions, 29 %). Benign bone lesions were exclusively osteosclerotic and smaller than the metastases (mean size 6 mm vs. 23 mm). While PET/CT allowed identification of 45 of 48 bone metastases (94 %), PET/MRI allowed identification of all bone metastases (100 %). Conspicuity of metastases was high for both modalities with significantly better results using PET/MRI (p < 0.05). Diagnostic confidence in lesion detection was high for both modalities without a significant difference. In benign lesions, conspicuity and diagnostic confidence were significantly higher with PET/CT (p < 0.05).


[18 F]FDG PET/MRI shows high potential for the assessment of bone metastases by offering superior lesion conspicuity when compared to PET/CT. In hypersclerotic, benign bone lesions PET/CT still sets the reference.

Key Points

PET/MRI and PET/CT are of equal value for the identification of disease-positive patients

PET/MRI offers higher lesion conspicuity as well as diagnostic confidence

PET/MRI is an attractive new alternative for the assessment of bone metastases

Key words

PET/MRI PET/CT Bone metastases Oncology [18 F]FDG 



The scientific guarantor of this article is Thomas C. Lauenstein. The authors of this article declare relationships with the following companies: Bayer Healthcare (Lale Umutlu, consultant),and Siemens Healthcare (Hilmar Kuehl, speaker honoraria). This study received funding from the German Research Foundation (DFG, Deutsche Forschungsgemeinschaft; funding AN 397/3-1). One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic study, performed at one institution.

We wish to thank the technical staff for their excellent work, especially Sebastian Blex, Samantha Horry, Julia Joos and Madeleine Fink.


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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Karsten Beiderwellen
    • 1
  • Michael Huebner
    • 1
  • Philipp Heusch
    • 3
  • Johannes Grueneisen
    • 1
  • Verena Ruhlmann
    • 2
  • Felix Nensa
    • 1
  • Hilmar Kuehl
    • 1
  • Lale Umutlu
    • 1
  • Sandra Rosenbaum-Krumme
    • 2
  • Thomas C. Lauenstein
    • 1
  1. 1.Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenUniversity of Duisburg-EssenEssenGermany
  2. 2.Department of Nuclear Medicine, University Hospital EssenUniversity of Duisburg-EssenEssenGermany
  3. 3.Department of Diagnostic and Interventional Radiology, Medical FacultyUniversity of DuesseldorfDuesseldorfGermany

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