PET/MRI offers diagnostic accuracy for lymph node staging

Sunday, November 25 | 11:15 a.m.-11:25 a.m. | SSA12-04 | Room S504CD
PET/MRI provides sufficient diagnostic accuracy for lymph node metastases detection, while diffusion-weighted MRI (DWI-MRI) images are inaccurate for staging in head and neck cancer patients, according to researchers from the University of Düsseldorf.

Lead study author Dr. Christian Buchbender, from the department of diagnostic and interventional radiology, and colleagues evaluated DWI-MRI, FDG-PET, and PET/MRI for staging head and neck cancer patients.

Preoperative 3-tesla MRI, including DWI and gadolinium-enhanced sequences, and FDG-PET/CT were performed in 14 consecutive head and neck cancer patients with a mean age of 67 years. Using image fusion software, PET and DWI images were combined with corresponding T1-weighted, gadolinium-enhanced MRI studies.

PET/MRI detected 26 of 28 (93%) positive lymph node metastases, compared with 20 of 28 (71%) metastases for DWI-MRI, according to the researchers. In addition, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/MRI were greater in all five categories compared with DWI-MRI.

"Our approach was to find out if the number of initially false-negative neck scans can be reduced by the use of molecular MRI information in simultaneous FDG-PET/MRI," Buchbender said. "However, according to our first results, the use of 'PET-like' DWI did not increase the sensitivity of lymph node metastases detection compared to FDG-PET/CT. We plan to evaluate whether the combination of FDG-PET/MRI plus DWI does perform better in this task."

Now that simultaneous PET/MRI is available, Buchbender and colleagues have started to combine several MRI parameters with FDG-PET to find out if such a combination achieves a higher detection rate for lymph node metastases and, if so, which combination is the most beneficial.

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