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The Performance Comparison of 18F-FDG PET/MRI and 18F-FDG PET/CT for the Identification of Pancreatic Neoplasms

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To determine the optimal imaging tool for clinical evaluation of pancreatic neoplasm by comparing the performance of 18F-FDG PET/MRI and PET/CT.


Patients with suspected pancreatic neoplasms underwent PET/MRI and PET/CT in the same day prior to resection or endoscopic ultrasound-guided fine-needle aspiration. Histology served as the golden standard of lesion classification. Visual assessment on lesion type and lesion malignancy via PET/MRI and PET/CT images was compared. Standard uptake values (SUVs) of PET images from the two scanners were measured and their correlations were further evaluated.


Thirty-nine patients were included for the final analysis. In visual assessment, we found MRI achieved better performance than CT in differentiating solid and cystic neoplasms, with accuracy of 100% vs. 87%, respectively. In visual malignancy diagnosis, the accuracy of PET/CT was 92.3% for overall lesions and 90.9% for cysts, while the accuracy of PET/MRI was 92.3% and 86.4%, respectively. Besides, semi-quantitative analysis achieved better specificity than visual assessment for both hybrid modalities (100% vs. 87.5% for PET/CT; 100% vs. 81.5% for PET/MR). Furthermore, strong correlation of SUV was found between PET/CT and PET/MRI, with Pearson’s correlation coefficients > 0.82.


In this study, we found PET/MRI and PET/CT, both using 18F-FDG as tracer, had comparable overall performance in identification of pancreatic neoplasms. Interestingly, for patients who had suspected pancreatic neoplasm but invisible FDG uptake, PET/MRI had shown exceptionally better performance, probably because MR images could detect tiny abnormal structures to improve diagnosis.

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This work was sponsored in part by the National Key Research and Development Program of China (No. 2020YFC2002702), the National Natural Science Foundation of China (No. 82071967), CAMS initiative for innovative medicine (No. 2016ZX310174-4), and Capital’s Funds for Health Improvement and Research (No. CFH-2018–2-4014).

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Correspondence to Li Huo.

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Xing, H., Ding, H., Hou, B. et al. The Performance Comparison of 18F-FDG PET/MRI and 18F-FDG PET/CT for the Identification of Pancreatic Neoplasms. Mol Imaging Biol 24, 489–497 (2022).

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