Advertisement

Japanese Journal of Radiology

, Volume 28, Issue 2, pp 95–100 | Cite as

Diagnostic performance of fluorodeoxyglucose positron emission tomography/magnetic resonance imaging fusion images of gynecological malignant tumors: comparison with positron emission tomography/computed tomography

  • Kazuya Nakajo
  • Mitsuaki Tatsumi
  • Atsuo Inoue
  • Kayako Isohashi
  • Ichiro Higuchi
  • Hiroki Kato
  • Masao Imaizumi
  • Takayuki Enomoto
  • Eku Shimosegawa
  • Tadashi Kimura
  • Jun HatazawaEmail author
Original Article

Abstract

Purpose

We compared the diagnostic accuracy of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and PET/magnetic resonance imaging (MRI) fusion images for gynecological malignancies.

Materials and methods

A total of 31 patients with gynecological malignancies were enrolled. FDG-PET images were fused to CT, T1- and T2-weighted images (T1WI, T2WI). PET-MRI fusion was performed semiautomatically. We performed three types of evaluation to demonstrate the usefulness of PET/MRI fusion images in comparison with that of inline PET/CT as follows: depiction of the uterus and the ovarian lesions on CT or MRI mapping images (first evaluation); additional information for lesion localization with PET and mapping images (second evaluation); and the image quality of fusion on interpretation (third evaluation).

Results

For the first evaluation, the score for T2WI (4.68 ± 0.65) was significantly higher than that for CT (3.54 ± 1.02) or T1WI (3.71 ± 0.97) (P < 0.01). For the second evaluation, the scores for the localization of FDG accumulation showing that T2WI (2.74 ± 0.57) provided significantly more additional information for the identification of anatomical sites of FDG accumulation than did CT (2.06 ± 0.68) or T1WI (2.23 ± 0.61) (P < 0.01). For the third evaluation, the three-point rating scale for the patient group as a whole demonstrated that PET/T2WI (2.72 ± 0.54) localized the lesion significantly more convincingly than PET/CT (2.23 ± 0.50) or PET/T1WI (2.29 ± 0.53) (P < 0.01).

Conclusion

PET/T2WI fusion images are superior for the detection and localization of gynecological malignancies.

Key words

PET MRI Fusion image Gynecological malignant tumors 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Blodgett TM, Meltzer CC, Townsend DW. PET/CT: form and function. Radiology 2007;242:360–385.CrossRefPubMedGoogle Scholar
  2. 2.
    Kluetz PG, Meltzer CC, Villemagne VL, Kinahan PE, Chander S, Martinelli MA, et al. Combined PET/CT imaging in oncology: impact on patient management. Clin Positron Imaging 2000;3:223–230.CrossRefPubMedGoogle Scholar
  3. 3.
    Pui MH, Wang QY, Xu B, Fan GP. MRI of gynecological neoplasm. Clin Imaging 2004;28:143–152.CrossRefPubMedGoogle Scholar
  4. 4.
    Nicolet V, Carignan L, Bourdon F, Prosmanne O. MR imaging of cervical carcinoma: a practical staging approach. Radiographics 2000;20:1539–1549.PubMedGoogle Scholar
  5. 5.
    Imaoka I, Wada A, Kaji Y, Hayashi T, Hayashi M, Matsuo M, et al. Developing an MR imaging strategy for diagnosis of ovarian masses. Radiographics 2006;26:1431–1448.CrossRefPubMedGoogle Scholar
  6. 6.
    Rosset A, Spadola L, Ratib O. Osiri X. An open-source software for navigating in multidimensional DICOM images. J Digit Imaging 2004;17:205–216.CrossRefPubMedGoogle Scholar
  7. 7.
    Kim SH, Choi BI, Han JK, Kim HD, Lee HP, Kang SB, et al. Preoperative staging of uterine cervical carcinoma: comparison of CT and MRI in 99 patients. J Comput Assist Tomogr 1993;17:633–640.PubMedCrossRefGoogle Scholar
  8. 8.
    Varpula MJ, Klemi PJ. Staging of uterine endometrial carcinoma with ultra-low field (0.02 T) MRI: a comparative study with CT. J Comput Assist Tomogr 1993;17:641–647.CrossRefPubMedGoogle Scholar
  9. 9.
    Hricak H, Gatsonis C, Coakley FV, Snyder B, Reinhold C, Schwartz LH, et al. Early invasive cervical cancer: CT and MR imaging in preoperative evaluation: ACRIN/GOG comparative study of diagnostic performance and interobserver variability. Radiology 2007;245:491–498.CrossRefPubMedGoogle Scholar
  10. 10.
    Rieber A, Nussle K, Stohr I, Grab D, Fenchel S, Kreienberg R, et al. Preoperative diagnosis of ovarian tumors with MR imaging: comparison with transvaginal sonography, positron emission tomography, and histologic findings. AJR Am J Roentgenol 2001;177:123–129.PubMedGoogle Scholar
  11. 11.
    Basu S, Li G, Alavi A. PET and PET-CT imaging of gynecological malignancies: present role and future promise. Expert Rev Anticancer Ther 2009;9:75–96.CrossRefPubMedGoogle Scholar
  12. 12.
    Kim SK, Choi HJ, Park SY, Lee HY, Seo SS, Yoo CW, et al. Additional value of MR/PET fusion compared with PET/CT in the detection of lymph node metastases in cervical cancer patients. Eur J Cancer 2009;45:2103–2109.CrossRefPubMedGoogle Scholar
  13. 13.
    Park JY, Kim EN, Kim DY, Suh DS, Kim JH, Kim YM, et al. Comparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer. Gynecol Oncol 2008;108:486–492.CrossRefPubMedGoogle Scholar
  14. 14.
    Zasadny KR, Wahl RL. Standardized uptake values of normal tissues at PET with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose: variations with body weight and a method for correction. Radiology 1993;189:847–850.PubMedGoogle Scholar
  15. 15.
    Liu Y. Benign ovarian and endometrial uptake on FDG PET-CT: patterns and pitfalls. Ann Nucl Med 2009;23:107–112.CrossRefPubMedGoogle Scholar
  16. 16.
    Yen TC, See LC, Lai CH, Tsai CS, Chao A, Hsueh S, et al. Standardized uptake value in para-aortic lymph nodes is a significant prognostic factor in patients with primary advanced squamous cervical cancer. Eur J Nucl Med Mol Imaging 2008;35:493–501.CrossRefPubMedGoogle Scholar
  17. 17.
    Lai CH, Huang KG, See LC, Yen TC, Tsai CS, Chang TC, et al. Restaging of recurrent cervical carcinoma with dualphase [18F]fluoro-2-deoxy-d-glucose positron emission tomography. Cancer 2004;100:544–552.CrossRefPubMedGoogle Scholar
  18. 18.
    Mawlawi O, Erasmus JJ, Munden RF, Pan T, Knight AE, Macapinlac HA, et al. Quantifying the effect of IV contrast media on integrated PET/CT: clinical evaluation. AJR Am J Roentgenol 2006;186:308–319.CrossRefPubMedGoogle Scholar
  19. 19.
    Kitajima K, Murakami K, Yamasaki E, Kaji Y, Fukasawa I, Inaba N, et al. Diagnostic accuracy of integrated FDG-PET/ contrast-enhanced CT in staging ovarian cancer: comparison with enhanced CT. Eur J Nucl Med Mol Imaging 2008;35:1912–1920.CrossRefPubMedGoogle Scholar
  20. 20.
    Judenhofer MS, Catana C, Swann BK, Siegel SB, Jung WI, Nutt RE, et al. PET/MR images acquired with a compact MR-compatible PET detector in a 7-T magnet. Radiology 2007;244:807–814.CrossRefPubMedGoogle Scholar
  21. 21.
    Imaizumi M, Yamamoto S, Kawakami M, Aoki M. Simultaneous imaging of magnetic resonance imaging and positron emission tomography by means of MRI-compatible optic fiber based PET: a validation study in ex vivo rat brain. Jpn J Radiol 2009;27:252–256.CrossRefPubMedGoogle Scholar

Copyright information

© Japan Radiological Society 2010

Authors and Affiliations

  • Kazuya Nakajo
    • 1
  • Mitsuaki Tatsumi
    • 1
  • Atsuo Inoue
    • 1
  • Kayako Isohashi
    • 1
  • Ichiro Higuchi
    • 1
  • Hiroki Kato
    • 1
  • Masao Imaizumi
    • 1
  • Takayuki Enomoto
    • 3
  • Eku Shimosegawa
    • 1
  • Tadashi Kimura
    • 3
  • Jun Hatazawa
    • 1
    • 2
    Email author
  1. 1.Department of Nuclear Medicine and Tracer KineticsOsaka University Graduate School of MedicineSuitaJapan
  2. 2.Department of RadiologyOsaka University HospitalSuitaJapan
  3. 3.Department of Obstetrics and GynaecologyOsaka University Graduate School of MedicineSuitaJapan

Personalised recommendations