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Gadoxetate-enhanced versus diffusion-weighted MRI for fused Ga-68-DOTANOC PET/MRI in patients with neuroendocrine tumours of the upper abdomen

  • Oncology
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To compare fused gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI (diffusion-weighted imaging) for the assessment of abdominal neuroendocrine tumours (NETs).


Eighteen patients with suspected or histologically proven NETs of the abdomen were enrolled in this retrospective study. All patients underwent Ga-68-DOTANOC PET/CT for a primary search, staging, or restaging, and received an additional MRI, including dynamic gadoxetate-enhanced T1-weighted sequences and DWI (b-values 50, 300 and 600). Co-registered gadoxetate-enhanced PET/MRI and PET/DWI were separately analysed for NET lesions by a nuclear medicine physician and a radiologist in consensus. Sensitivity and specificity were calculated on a per-region, per-organ and per-patient basis.


Eighty-seven out of 684 anatomical regions, and 23 out of 270 organs, were NET-positive in 14 out of 18 patients. Region-based sensitivities and specificities were 97.7 % and 99.7 % for gadoxetate-enhanced PET/MRI and 98.9 % and 99.7 % for PET/DWI. Organ-based sensitivities and specificities were 91.3 % and 99.6 % for gadoxetate-enhanced PET/MRI and 95.7 % and 99.6 % for PET/DWI. Finally, patient-based sensitivities and specificities were 100 % and 100 % for gadoxetate-enhanced PET/MRI and 100 % and 75 % for PET/DWI. Sensitivities and specificities of the two methods did not differ significantly.


Gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI are equally useful for the assessment of abdominal NETs.

Key Points

Positron emission tomography and magnetic resonance imaging can both assess neuroendocrine tumours.

Fusion of PET/MR imaging provides helpful information.

Gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI assess neuroendocrine tumours equally well.

PET/DWI is inherently simpler than gadoxetate-enhanced PET/MRI.

Only benign hepatic lesions pose a potential diagnostic dilemma for PET/DWI.

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  1. Ambrosini V, Campana D, Tomassetti P, Grassetto G, Rubello D, Fanti S (2011) PET/CT with 68Gallium-DOTA-peptides in NET: an overview. Eur J Radiol 80:e116–e119

    Article  PubMed  Google Scholar 

  2. Scarpa M, Prando D, Pozza A, Esposti ED, Castoro C, Angriman I (2010) A systematic review of diagnostic procedures to detect midgut neuroendocrine tumours. J Surg Oncol 102:877–888

    Article  PubMed  Google Scholar 

  3. Schreiter NF, Nogami M, Steffen I et al (2012) Evaluation of the potential of PET-MRI fusion for detection of liver metastases in patients with neuroendocrine tumours. Eur Radiol 22:458–467

    Article  PubMed  Google Scholar 

  4. Giesel FL, Kratochwil C, Mehndiratta A et al (2012) Comparison of neuroendocrine tumour detection and characterization using DOTATOC-PET in correlation with contrast enhanced CT and delayed contrast enhanced MRI. Eur J Radiol 81:2820–2825

    Article  PubMed  CAS  Google Scholar 

  5. Ba-Ssalamah A, Uffmann M, Saini S, Bastati N, Herold C, Schima W (2009) Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions. Eur Radiol 19:342–357

    Article  PubMed  Google Scholar 

  6. Taouli B, Koh DM (2010) Diffusion-weighted MR imaging of the liver. Radiology 254:47–66

    Article  PubMed  Google Scholar 

  7. Soussan M, Des Guetz G, Barrau V et al (2012) Comparison of FDG-PET/CT and MR with diffusion-weighted imaging for assessing peritoneal carcinomatosis from gastrointestinal malignancy. Eur Radiol 22:1479–1487

    Article  PubMed  Google Scholar 

  8. Martincich L, Deantoni V, Bertotto I et al (2012) Correlations between diffusion-weighted imaging and breast cancer biomarkers. Eur Radiol 22:1519–1528

    Article  PubMed  Google Scholar 

  9. Wu X, Kellokumpu-Lehtinen PL, Pertovaara H et al (2011) Diffusion-weighted MRI in early chemotherapy response evaluation of patients with diffuse large B-cell lymphoma—a pilot study: comparison with 2-deoxy-2-fluoro- D-glucose-positron emission tomography/computed tomography. NMR Biomed 24:1181–1190

    Article  PubMed  CAS  Google Scholar 

  10. Zech CJ, Herrmann KA, Dietrich O, Horger W, Reiser MF, Schoenberg SO (2008) Black-blood diffusion-weighted EPI acquisition of the liver with parallel imaging: comparison with a standard T2-weighted sequence for detection of focal liver lesions. Investig Radiol 43:261–266

    Article  Google Scholar 

  11. van den Bos IC, Hussain SM, Krestin GP, Wielopolski PA (2008) Liver imaging at 3.0 T: diffusion-induced black-blood echo-planar imaging with large anatomic volumetric coverage as an alternative for specific absorption rate-intensive echo-train spin-echo sequences: feasibility study. Radiology 248:264–271

    Article  PubMed  Google Scholar 

  12. Parikh T, Drew SJ, Lee VS et al (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822

    Article  PubMed  Google Scholar 

  13. Eidherr H, Girschele F, Mitterhauser M, Wadsak W (2012) Synthesis of [68Ga]gallium DOTA-(Tyr3)-octreotide acetate (68Ga-DOTATOC). In: Scott PJH, Hockley BG (eds) Radiochemical syntheses, vol 1, radiopharmaceuticals for positron emission tomography. Wiley, Hoboken. doi:10.1002/9781118140345.ch32

    Google Scholar 

  14. Mayerhoefer ME, Schuetz M, Magnaldi S, Weber M, Trattnig S, Karanikas G (2012) Are contrast media required for 68Ga-DOTATOC PET/CT in patients with neuroendocrine tumours of the abdomen? Eur Radiol 22:938–946

    Article  PubMed  Google Scholar 

  15. Kumar R, Sharma P, Garg P, Karunanithi S et al (2011) Role of 68Ga-DOTATOC PET-CT in the diagnosis and staging of pancreatic neuroendocrine tumours. Eur Radiol 21:2408–2416

    Article  PubMed  Google Scholar 

  16. Kartalis N, Lindholm TL, Aspelin P, Permert J, Albiin N (2009) Diffusion-weighted magnetic resonance imaging of pancreas tumours. Eur Radiol 19:1981–1990

    Article  PubMed  Google Scholar 

  17. Alibek S, Cavallaro A, Aplas A, Uder M, Staatz G (2009) Diffusion weighted imaging of pediatric and adolescent malignancies with regard to detection and delineation: initial experience. Acad Radiol 16:866–871

    Article  PubMed  Google Scholar 

  18. Coenegrachts K, Matos C, ter Beek L et al (2009) Focal liver lesion detection and characterization: comparison of non-contrast enhanced and SPIO-enhanced diffusion-weighted single-shot spin echo echo planar and turbo spin echo T2-weighted imaging. Eur J Radiol 72:432–439

    Article  PubMed  Google Scholar 

  19. Kim YK, Lee MW, Lee WJ et al (2012) Diagnostic accuracy and sensitivity of diffusion-weighted and of gadoxetic acid-enhanced 3-T MR imaging alone or in combination in the detection of small liver metastasis (≤ 1.5 cm in diameter). Investig Radiol 47:159–166

    CAS  Google Scholar 

  20. Chung WS, Kim MJ, Chung YE et al (2011) Comparison of gadoxetic acid-enhanced dynamic imaging and diffusion-weighted imaging for the preoperative evaluation of colorectal liver metastases. J Magn Reson Imaging 34:345–353

    Article  PubMed  Google Scholar 

  21. Sankowski AJ, CĆwikla JB, Nowicki ML et al (2012) The clinical value of MRI using single-shot echoplanar DWI to identify liver involvement in patients with advanced gastroenteropancreatic-neuroendocrine tumors (GEP-NETs), compared to FSE T2 and FFE T1 weighted image after i.v. Gd-EOB-DTPA contrast enhancement. Med Sci Monit 18:MT33–MT40

    Article  PubMed  Google Scholar 

  22. Shimada K, Isoda H, Hirokawa Y, Arizono S, Shibata T, Togashi K (2010) Comparison of gadolinium-EOB-DTPA-enhanced and diffusion-weighted liver MRI for detection of small hepatic metastases. Eur Radiol 20:2690–2698

    Article  PubMed  Google Scholar 

  23. Pfannenberg C, Schraml C, Schwenzer N et al (2011) Comparison of [68Ga]DOTATOC-PET/CT and whole-body MRI in staging of neuroendocrine tumours. Cancer Imaging 11:S38–S39

    Article  Google Scholar 

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Correspondence to Marius E. Mayerhoefer.

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Mayerhoefer, M.E., Ba-Ssalamah, A., Weber, M. et al. Gadoxetate-enhanced versus diffusion-weighted MRI for fused Ga-68-DOTANOC PET/MRI in patients with neuroendocrine tumours of the upper abdomen. Eur Radiol 23, 1978–1985 (2013).

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