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Hybrid PET/MRI in major cancers: a scoping review

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

PET/MRI was introduced for clinical use in 2011 and is now an established modality for the imaging of brain and certain pelvic cancers, whereas clinical use for the imaging of other forms of cancer is not yet widespread. We therefore systematically investigated what has been published on the use of PET/MRI compared to PET/CT in the imaging of cancers outside the brain, focusing on clinical areas of application related to diagnosis, staging and restaging.

Methods

A systematic search of PubMed/MEDLINE, Embase and the Cochrane Library was performed. Studies evaluating the diagnostic performance of simultaneous PET/MRI in cancer patients were chosen.

Results

A total of 3,138 publications were identified and 116 published during the period 2012–2018 were included and were grouped according to the major cancer forms: 13 head and neck (HNC), 9 breast (BC), 21 prostate (PC), 14 gynaecological, 13 gastrointestinal (GIC), and 46 various cancers. Data from studies comparing PET/MRI and PET/CT for staging/restaging suggested the superiority of 18F-FDG PET/MRI for the detection of tumour extension and retropharyngeal lymph node metastases in nasopharyngeal cancer, and for the detection of liver metastases and possibly bone marrow metastases in high-risk BC. FDG PET/MRI tended to be inferior for the detection of lung metastases in HNC and BC. 68Ga-PSMA-11 PET/MRI was superior to PET/CT for the detection of local PC recurrence. FDG PET/MRI was superior to FDG PET/CT for the detection of local tumour invasion in cervical cancer and had higher accuracy for the detection of liver metastases in colorectal cancer.

Conclusion

The scoping review methodology resulted in the identification of a huge number of records, of which less than 5% were suitable for inclusion and only a limited number allowed conclusions on the advantages/disadvantages of PET/MRI compared to PET/CT in the oncological setting. There was evidence to support the use of FDG PET/MRI in staging of nasopharyngeal cancer and high-risk BC. Preliminary data indicate the superiority of PET/MRI for the detection of local recurrence in PC, local tumour invasion in cervical cancer, and liver metastases in colorectal cancer. These conclusions are based on small datasets and need to be further explored.

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Acknowledgements

Research librarian L. Østengaard, PhD, University Library of Southern Denmark and Head of Department, and Associate Professor J.S. Madsen, Biochemistry and Immunology, Institute of Regional Health Research, University of Southern Denmark are acknowledged for help with the literature search.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark

    Anni Morsing, Malene Grubbe Hildebrandt, Mie Holm Vilstrup, Sara Elisabeth Wallenius, Oke Gerke, Henrik Petersen, Allan Johansen, Thomas Lund Andersen & Poul Flemming Høilund-Carlsen

  2. MAgNetic Resonance Technology for Response Adapted Radiotherapy (MANTRA), Odense University Hospital, Odense, Denmark

    Anni Morsing & Thomas Lund Andersen

  3. Research Unit of Clinical Physiology and Nuclear Medicine, Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Malene Grubbe Hildebrandt & Poul Flemming Høilund-Carlsen

  4. Centre for Innovative Medical Technology (CIMT), Odense University Hospital, Odense, Denmark

    Malene Grubbe Hildebrandt

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  1. Anni Morsing
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Correspondence to Anni Morsing.

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Morsing, A., Hildebrandt, M.G., Vilstrup, M.H. et al. Hybrid PET/MRI in major cancers: a scoping review. Eur J Nucl Med Mol Imaging 46, 2138–2151 (2019). https://doi.org/10.1007/s00259-019-04402-8

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