PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison
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To compare the diagnostic accuracy of PET/MRI and PET/CT for staging and re-staging advanced gynaecological cancer patients as well as identify the potential benefits of each method in such a population.
Material and methods
Twenty-six patients with suspicious or proven advanced gynaecological cancer (12 ovarian, seven cervical, one vulvar and four endometrial tumours, one uterine metastasis, and one primary peritoneal cancer) underwent whole-body imaging with a sequential trimodality PET/CT/MR system. Images were analysed regarding primary tumour detection and delineation, loco-regional lymph node staging, and abdominal/extra-abdominal distant metastasis detection (last only by PET/CT).
Eighteen (69.2 %) patients underwent PET/MRI for primary staging and eight patients (30.8 %) for re-staging their gynaecological malignancies. For primary tumour delineation, PET/MRI accuracy was statistically superior to PET/CT (p < 0.001). Among the different types of cancer, PET/MRI presented better tumour delineation mainly for cervical (6/7) and endometrial (2/3) cancers. PET/MRI for local evaluation as well as PET/CT for extra-abdominal metastases had therapeutic consequences in three and one patients, respectively. PET/CT detected 12 extra-abdominal distant metastases in 26 patients.
PET/MRI is superior to PET/CT for primary tumour delineation. No differences were found in detection of regional lymph node involvement and abdominal metastases detection.
• PET/MRI is superior to PET/CT for primary tumour delineation
• PET/CT represents a reliable tool to detect extra-abdominal distant metastasis
• PET/MRI might be the preferred imaging modality for staging cervical and endometrial tumours
• Whole-body staging for detection and evaluation of extra-abdominal metastases is mandatory
KeywordsPET/CT PET/MRI Advanced gynaecological tumours Staging Re-staging
The scientific guarantor of this publication is Patrick Veit-Haibach. The authors of this manuscript declare relationships with the following companies: GE Healthcare (P.V.H. and G.v.S), Bayer Healthcare (P.V.H.), Siemens Medical Solutions (P.V.H.) and Guerbet Switzerland (J.M.F.). The others authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by GE Healthcare. 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. No animals have been used in the study. None of the study subjects or cohorts have been previously reported. Methodology: prospective, diagnostic or prognostic study/performed at one institution.
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