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How to Provide Gadolinium-Free PET/MR Cancer Staging of Children and Young Adults in Less than 1 h: the Stanford Approach
Purpose To provide clinically useful gadolinium-free whole-body cancer staging of children and young adults with integrated positron emission tomography/magnetic resonance (PET/MR) imaging in less than 1 h. Procedures In this prospective clinical trial, 20 children and young adults (11–30 years old,...
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| Published in: | Molecular imaging and biology 2018-04, Vol.20 (2), p.324-335 |
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| creator | Muehe, Anne M. Theruvath, Ashok J. Lai, Lillian Aghighi, Maryam Quon, Andrew Holdsworth, Samantha J. Wang, Jia Luna-Fineman, Sandra Marina, Neyssa Advani, Ranjana Rosenberg, Jarrett Daldrup-Link, Heike E. |
| description | Purpose
To provide clinically useful gadolinium-free whole-body cancer staging of children and young adults with integrated positron emission tomography/magnetic resonance (PET/MR) imaging in less than 1 h.
Procedures
In this prospective clinical trial, 20 children and young adults (11–30 years old, 6 male, 14 female) with solid tumors underwent 2-deoxy-2-[
18
F]fluoro-
d
-glucose ([
18
F]FDG) PET/MR on a 3T PET/MR scanner after intravenous injection of ferumoxytol (5 mg Fe/kg) and [
18
F]FDG (2–3 MBq/kg). Time needed for patient preparation, PET/MR image acquisition, and data processing was compared before (
n
= 5) and after (
n
= 15) time-saving interventions, using a Wilcoxon test. The ferumoxytol-enhanced PET/MR images were compared with clinical standard staging tests regarding radiation exposure and tumor staging results, using Fisher’s exact tests.
Results
Tailored workflows significantly reduced scan times from 36 to 24 min for head to mid thigh scans (
p
|
| doi_str_mv | 10.1007/s11307-017-1105-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1920395399</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2016325588</sourcerecordid><originalsourceid>FETCH-LOGICAL-c415t-5808b6a44b4f3ed73867db09a679bfb89bd239679da61ecc962690b4f3062f0b3</originalsourceid><addsrcrecordid>eNp1kc9u1DAQxi0EoqXwAFyQJS69mM7YGzvmtlr1D9IiKigHTpYTO7upsvZiJ6D2aXgWngxHW0BC4uTx-Pd9Y81HyEuENwigzjKiAMUAFUOEiqlH5BhrCYwD8MelroRkKAU_Is9yvoUCIhdPyRGvFUcJ1TG5v4rf6RjpdYrfeufppXVx6EM_7dhF8p5en9-cvf9IVza0PtFPo930YUNjR1fbfnDJB2qDo1_iVLpLNw1jpn2ga58zHbc2UPz5Y_u2lH7Whi4mR5f7fYq23T4nTzo7ZP_i4Twhny_Ob1ZXbP3h8t1quWbtAquRVTXUjbSLRbPohHdK1FK5BrSVSjddU-vGcaHLxVmJvm215FLDDIPkHTTihJwefMvYr5PPo9n1ufXDYIOPUzaoOQhdCa0L-vof9DZOKZTfGQ7zIquqrguFB6pNMefkO7NP_c6mO4Ng5mDMIRhT9m3mYIwqmlcPzlOz8-6P4ncSBeAHIJensPHp7-j_u_4CNyiW1g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2016325588</pqid></control><display><type>article</type><title>How to Provide Gadolinium-Free PET/MR Cancer Staging of Children and Young Adults in Less than 1 h: the Stanford Approach</title><source>Springer Link</source><creator>Muehe, Anne M. ; Theruvath, Ashok J. ; Lai, Lillian ; Aghighi, Maryam ; Quon, Andrew ; Holdsworth, Samantha J. ; Wang, Jia ; Luna-Fineman, Sandra ; Marina, Neyssa ; Advani, Ranjana ; Rosenberg, Jarrett ; Daldrup-Link, Heike E.</creator><creatorcontrib>Muehe, Anne M. ; Theruvath, Ashok J. ; Lai, Lillian ; Aghighi, Maryam ; Quon, Andrew ; Holdsworth, Samantha J. ; Wang, Jia ; Luna-Fineman, Sandra ; Marina, Neyssa ; Advani, Ranjana ; Rosenberg, Jarrett ; Daldrup-Link, Heike E.</creatorcontrib><description>Purpose
To provide clinically useful gadolinium-free whole-body cancer staging of children and young adults with integrated positron emission tomography/magnetic resonance (PET/MR) imaging in less than 1 h.
Procedures
In this prospective clinical trial, 20 children and young adults (11–30 years old, 6 male, 14 female) with solid tumors underwent 2-deoxy-2-[
18
F]fluoro-
d
-glucose ([
18
F]FDG) PET/MR on a 3T PET/MR scanner after intravenous injection of ferumoxytol (5 mg Fe/kg) and [
18
F]FDG (2–3 MBq/kg). Time needed for patient preparation, PET/MR image acquisition, and data processing was compared before (
n
= 5) and after (
n
= 15) time-saving interventions, using a Wilcoxon test. The ferumoxytol-enhanced PET/MR images were compared with clinical standard staging tests regarding radiation exposure and tumor staging results, using Fisher’s exact tests.
Results
Tailored workflows significantly reduced scan times from 36 to 24 min for head to mid thigh scans (
p
< 0.001). These streamlined PET/MR scans were obtained with significantly reduced radiation exposure (mean 3.4 mSv) compared to PET/CT with diagnostic CT (mean 13.1 mSv;
p
= 0.003). Using the iron supplement ferumoxytol “off label” as an MR contrast agent avoided gadolinium chelate administration. The ferumoxytol-enhanced PET/MR scans provided equal or superior tumor staging results compared to clinical standard tests in 17 out of 20 patients. Compared to PET/CT, PET/MR had comparable detection rates for pulmonary nodules with diameters of equal or greater than 5 mm (94 vs. 100 %), yet detected significantly fewer nodules with diameters of less than 5 mm (20 vs 100 %) (
p
= 0.03). [
18
F]FDG-avid nodules were detected with slightly higher sensitivity on the PET of the PET/MR compared to the PET of the PET/CT (59 vs 49 %).
Conclusion
Our streamlined ferumoxytol-enhanced PET/MR protocol provided cancer staging of children and young adults in less than 1 h with equivalent or superior clinical information compared to clinical standard staging tests. The detection of small pulmonary nodules with PET/MR needs to be improved.</description><identifier>ISSN: 1536-1632</identifier><identifier>EISSN: 1860-2002</identifier><identifier>DOI: 10.1007/s11307-017-1105-7</identifier><identifier>PMID: 28721605</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Adults ; Cancer ; Chelates ; Child ; Children ; Computed tomography ; Data processing ; Diagnostic systems ; Exposure ; Fluorine isotopes ; Gadolinium ; Gadolinium - chemistry ; Glucose ; Humans ; Image acquisition ; Image enhancement ; Imaging ; Intravenous administration ; Iron ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - pathology ; Lung nodules ; Magnetic Resonance Imaging ; Medicine ; Medicine & Public Health ; Multimodal Imaging ; Neoplasm Staging ; Neoplasms - diagnostic imaging ; Neoplasms - pathology ; Nodules ; Positron emission ; Positron emission tomography ; Positron Emission Tomography Computed Tomography ; Radiation ; Radiation effects ; Radiology ; Research Article ; Solid tumors ; Thigh ; Tomography ; Tomography, X-Ray Computed ; Tumors ; Young Adult ; Young adults</subject><ispartof>Molecular imaging and biology, 2018-04, Vol.20 (2), p.324-335</ispartof><rights>World Molecular Imaging Society 2017</rights><rights>Molecular Imaging and Biology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-5808b6a44b4f3ed73867db09a679bfb89bd239679da61ecc962690b4f3062f0b3</citedby><cites>FETCH-LOGICAL-c415t-5808b6a44b4f3ed73867db09a679bfb89bd239679da61ecc962690b4f3062f0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28721605$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muehe, Anne M.</creatorcontrib><creatorcontrib>Theruvath, Ashok J.</creatorcontrib><creatorcontrib>Lai, Lillian</creatorcontrib><creatorcontrib>Aghighi, Maryam</creatorcontrib><creatorcontrib>Quon, Andrew</creatorcontrib><creatorcontrib>Holdsworth, Samantha J.</creatorcontrib><creatorcontrib>Wang, Jia</creatorcontrib><creatorcontrib>Luna-Fineman, Sandra</creatorcontrib><creatorcontrib>Marina, Neyssa</creatorcontrib><creatorcontrib>Advani, Ranjana</creatorcontrib><creatorcontrib>Rosenberg, Jarrett</creatorcontrib><creatorcontrib>Daldrup-Link, Heike E.</creatorcontrib><title>How to Provide Gadolinium-Free PET/MR Cancer Staging of Children and Young Adults in Less than 1 h: the Stanford Approach</title><title>Molecular imaging and biology</title><addtitle>Mol Imaging Biol</addtitle><addtitle>Mol Imaging Biol</addtitle><description>Purpose
To provide clinically useful gadolinium-free whole-body cancer staging of children and young adults with integrated positron emission tomography/magnetic resonance (PET/MR) imaging in less than 1 h.
Procedures
In this prospective clinical trial, 20 children and young adults (11–30 years old, 6 male, 14 female) with solid tumors underwent 2-deoxy-2-[
18
F]fluoro-
d
-glucose ([
18
F]FDG) PET/MR on a 3T PET/MR scanner after intravenous injection of ferumoxytol (5 mg Fe/kg) and [
18
F]FDG (2–3 MBq/kg). Time needed for patient preparation, PET/MR image acquisition, and data processing was compared before (
n
= 5) and after (
n
= 15) time-saving interventions, using a Wilcoxon test. The ferumoxytol-enhanced PET/MR images were compared with clinical standard staging tests regarding radiation exposure and tumor staging results, using Fisher’s exact tests.
Results
Tailored workflows significantly reduced scan times from 36 to 24 min for head to mid thigh scans (
p
< 0.001). These streamlined PET/MR scans were obtained with significantly reduced radiation exposure (mean 3.4 mSv) compared to PET/CT with diagnostic CT (mean 13.1 mSv;
p
= 0.003). Using the iron supplement ferumoxytol “off label” as an MR contrast agent avoided gadolinium chelate administration. The ferumoxytol-enhanced PET/MR scans provided equal or superior tumor staging results compared to clinical standard tests in 17 out of 20 patients. Compared to PET/CT, PET/MR had comparable detection rates for pulmonary nodules with diameters of equal or greater than 5 mm (94 vs. 100 %), yet detected significantly fewer nodules with diameters of less than 5 mm (20 vs 100 %) (
p
= 0.03). [
18
F]FDG-avid nodules were detected with slightly higher sensitivity on the PET of the PET/MR compared to the PET of the PET/CT (59 vs 49 %).
Conclusion
Our streamlined ferumoxytol-enhanced PET/MR protocol provided cancer staging of children and young adults in less than 1 h with equivalent or superior clinical information compared to clinical standard staging tests. The detection of small pulmonary nodules with PET/MR needs to be improved.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Cancer</subject><subject>Chelates</subject><subject>Child</subject><subject>Children</subject><subject>Computed tomography</subject><subject>Data processing</subject><subject>Diagnostic systems</subject><subject>Exposure</subject><subject>Fluorine isotopes</subject><subject>Gadolinium</subject><subject>Gadolinium - chemistry</subject><subject>Glucose</subject><subject>Humans</subject><subject>Image acquisition</subject><subject>Image enhancement</subject><subject>Imaging</subject><subject>Intravenous administration</subject><subject>Iron</subject><subject>Lung Neoplasms - diagnostic imaging</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung nodules</subject><subject>Magnetic Resonance Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multimodal Imaging</subject><subject>Neoplasm Staging</subject><subject>Neoplasms - diagnostic imaging</subject><subject>Neoplasms - pathology</subject><subject>Nodules</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Radiation</subject><subject>Radiation effects</subject><subject>Radiology</subject><subject>Research Article</subject><subject>Solid tumors</subject><subject>Thigh</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumors</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1536-1632</issn><issn>1860-2002</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kc9u1DAQxi0EoqXwAFyQJS69mM7YGzvmtlr1D9IiKigHTpYTO7upsvZiJ6D2aXgWngxHW0BC4uTx-Pd9Y81HyEuENwigzjKiAMUAFUOEiqlH5BhrCYwD8MelroRkKAU_Is9yvoUCIhdPyRGvFUcJ1TG5v4rf6RjpdYrfeufppXVx6EM_7dhF8p5en9-cvf9IVza0PtFPo930YUNjR1fbfnDJB2qDo1_iVLpLNw1jpn2ga58zHbc2UPz5Y_u2lH7Whi4mR5f7fYq23T4nTzo7ZP_i4Twhny_Ob1ZXbP3h8t1quWbtAquRVTXUjbSLRbPohHdK1FK5BrSVSjddU-vGcaHLxVmJvm215FLDDIPkHTTihJwefMvYr5PPo9n1ufXDYIOPUzaoOQhdCa0L-vof9DZOKZTfGQ7zIquqrguFB6pNMefkO7NP_c6mO4Ng5mDMIRhT9m3mYIwqmlcPzlOz8-6P4ncSBeAHIJensPHp7-j_u_4CNyiW1g</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Muehe, Anne M.</creator><creator>Theruvath, Ashok J.</creator><creator>Lai, Lillian</creator><creator>Aghighi, Maryam</creator><creator>Quon, Andrew</creator><creator>Holdsworth, Samantha J.</creator><creator>Wang, Jia</creator><creator>Luna-Fineman, Sandra</creator><creator>Marina, Neyssa</creator><creator>Advani, Ranjana</creator><creator>Rosenberg, Jarrett</creator><creator>Daldrup-Link, Heike E.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>L6V</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>7X8</scope></search><sort><creationdate>20180401</creationdate><title>How to Provide Gadolinium-Free PET/MR Cancer Staging of Children and Young Adults in Less than 1 h: the Stanford Approach</title><author>Muehe, Anne M. ; Theruvath, Ashok J. ; Lai, Lillian ; Aghighi, Maryam ; Quon, Andrew ; Holdsworth, Samantha J. ; Wang, Jia ; Luna-Fineman, Sandra ; Marina, Neyssa ; Advani, Ranjana ; Rosenberg, Jarrett ; Daldrup-Link, Heike E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-5808b6a44b4f3ed73867db09a679bfb89bd239679da61ecc962690b4f3062f0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Cancer</topic><topic>Chelates</topic><topic>Child</topic><topic>Children</topic><topic>Computed tomography</topic><topic>Data processing</topic><topic>Diagnostic systems</topic><topic>Exposure</topic><topic>Fluorine isotopes</topic><topic>Gadolinium</topic><topic>Gadolinium - chemistry</topic><topic>Glucose</topic><topic>Humans</topic><topic>Image acquisition</topic><topic>Image enhancement</topic><topic>Imaging</topic><topic>Intravenous administration</topic><topic>Iron</topic><topic>Lung Neoplasms - diagnostic imaging</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung nodules</topic><topic>Magnetic Resonance Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multimodal Imaging</topic><topic>Neoplasm Staging</topic><topic>Neoplasms - diagnostic imaging</topic><topic>Neoplasms - pathology</topic><topic>Nodules</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Radiation</topic><topic>Radiation effects</topic><topic>Radiology</topic><topic>Research Article</topic><topic>Solid tumors</topic><topic>Thigh</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumors</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muehe, Anne M.</creatorcontrib><creatorcontrib>Theruvath, Ashok J.</creatorcontrib><creatorcontrib>Lai, Lillian</creatorcontrib><creatorcontrib>Aghighi, Maryam</creatorcontrib><creatorcontrib>Quon, Andrew</creatorcontrib><creatorcontrib>Holdsworth, Samantha J.</creatorcontrib><creatorcontrib>Wang, Jia</creatorcontrib><creatorcontrib>Luna-Fineman, Sandra</creatorcontrib><creatorcontrib>Marina, Neyssa</creatorcontrib><creatorcontrib>Advani, Ranjana</creatorcontrib><creatorcontrib>Rosenberg, Jarrett</creatorcontrib><creatorcontrib>Daldrup-Link, Heike E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Biological Science Journals</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>MEDLINE - Academic</collection><jtitle>Molecular imaging and biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muehe, Anne M.</au><au>Theruvath, Ashok J.</au><au>Lai, Lillian</au><au>Aghighi, Maryam</au><au>Quon, Andrew</au><au>Holdsworth, Samantha J.</au><au>Wang, Jia</au><au>Luna-Fineman, Sandra</au><au>Marina, Neyssa</au><au>Advani, Ranjana</au><au>Rosenberg, Jarrett</au><au>Daldrup-Link, Heike E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How to Provide Gadolinium-Free PET/MR Cancer Staging of Children and Young Adults in Less than 1 h: the Stanford Approach</atitle><jtitle>Molecular imaging and biology</jtitle><stitle>Mol Imaging Biol</stitle><addtitle>Mol Imaging Biol</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>20</volume><issue>2</issue><spage>324</spage><epage>335</epage><pages>324-335</pages><issn>1536-1632</issn><eissn>1860-2002</eissn><abstract>Purpose
To provide clinically useful gadolinium-free whole-body cancer staging of children and young adults with integrated positron emission tomography/magnetic resonance (PET/MR) imaging in less than 1 h.
Procedures
In this prospective clinical trial, 20 children and young adults (11–30 years old, 6 male, 14 female) with solid tumors underwent 2-deoxy-2-[
18
F]fluoro-
d
-glucose ([
18
F]FDG) PET/MR on a 3T PET/MR scanner after intravenous injection of ferumoxytol (5 mg Fe/kg) and [
18
F]FDG (2–3 MBq/kg). Time needed for patient preparation, PET/MR image acquisition, and data processing was compared before (
n
= 5) and after (
n
= 15) time-saving interventions, using a Wilcoxon test. The ferumoxytol-enhanced PET/MR images were compared with clinical standard staging tests regarding radiation exposure and tumor staging results, using Fisher’s exact tests.
Results
Tailored workflows significantly reduced scan times from 36 to 24 min for head to mid thigh scans (
p
< 0.001). These streamlined PET/MR scans were obtained with significantly reduced radiation exposure (mean 3.4 mSv) compared to PET/CT with diagnostic CT (mean 13.1 mSv;
p
= 0.003). Using the iron supplement ferumoxytol “off label” as an MR contrast agent avoided gadolinium chelate administration. The ferumoxytol-enhanced PET/MR scans provided equal or superior tumor staging results compared to clinical standard tests in 17 out of 20 patients. Compared to PET/CT, PET/MR had comparable detection rates for pulmonary nodules with diameters of equal or greater than 5 mm (94 vs. 100 %), yet detected significantly fewer nodules with diameters of less than 5 mm (20 vs 100 %) (
p
= 0.03). [
18
F]FDG-avid nodules were detected with slightly higher sensitivity on the PET of the PET/MR compared to the PET of the PET/CT (59 vs 49 %).
Conclusion
Our streamlined ferumoxytol-enhanced PET/MR protocol provided cancer staging of children and young adults in less than 1 h with equivalent or superior clinical information compared to clinical standard staging tests. The detection of small pulmonary nodules with PET/MR needs to be improved.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28721605</pmid><doi>10.1007/s11307-017-1105-7</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1536-1632 |
| ispartof | Molecular imaging and biology, 2018-04, Vol.20 (2), p.324-335 |
| issn | 1536-1632 1860-2002 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1920395399 |
| source | Springer Link |
| subjects | Adolescent Adult Adults Cancer Chelates Child Children Computed tomography Data processing Diagnostic systems Exposure Fluorine isotopes Gadolinium Gadolinium - chemistry Glucose Humans Image acquisition Image enhancement Imaging Intravenous administration Iron Lung Neoplasms - diagnostic imaging Lung Neoplasms - pathology Lung nodules Magnetic Resonance Imaging Medicine Medicine & Public Health Multimodal Imaging Neoplasm Staging Neoplasms - diagnostic imaging Neoplasms - pathology Nodules Positron emission Positron emission tomography Positron Emission Tomography Computed Tomography Radiation Radiation effects Radiology Research Article Solid tumors Thigh Tomography Tomography, X-Ray Computed Tumors Young Adult Young adults |
| title | How to Provide Gadolinium-Free PET/MR Cancer Staging of Children and Young Adults in Less than 1 h: the Stanford Approach |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T05%3A12%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=How%20to%20Provide%20Gadolinium-Free%20PET/MR%20Cancer%20Staging%20of%20Children%20and%20Young%20Adults%20in%20Less%20than%201%C2%A0h:%20the%20Stanford%20Approach&rft.jtitle=Molecular%20imaging%20and%20biology&rft.au=Muehe,%20Anne%20M.&rft.date=2018-04-01&rft.volume=20&rft.issue=2&rft.spage=324&rft.epage=335&rft.pages=324-335&rft.issn=1536-1632&rft.eissn=1860-2002&rft_id=info:doi/10.1007/s11307-017-1105-7&rft_dat=%3Cproquest_cross%3E2016325588%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c415t-5808b6a44b4f3ed73867db09a679bfb89bd239679da61ecc962690b4f3062f0b3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2016325588&rft_id=info:pmid/28721605&rfr_iscdi=true |