Prospective comparison of 18 F-FDG PET/MRI and 18 F-FDG PET/CT for thoracic staging of non-small cell lung cancer

• Published in: European journal of nuclear medicine and molecular imaging 2019-02, Vol.46 (2), p.437
• Main Authors: Kirchner, Julian, Sawicki, Lino M, Nensa, Felix, Schaarschmidt, Benedikt M, Reis, Henning, Ingenwerth, Marc, Bogner, Simon, Aigner, Clemens, Buchbender, Christian, Umutlu, Lale, Antoch, Gerald, Herrmann, Ken, Heusch, Philipp
• Format: Article
• Language: English
• Subjects: Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - pathology; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Prospective Studies; Thorax
• ISSN: 1619-7089

To compare the diagnostic performance of F-FDG PET/MRI and F-FDG PET/CT for primary and locoregional lymph node staging in non-small cell lung cancer (NSCLC). In this prospective study, a total of 84 patients (51 men, 33 women, mean age 62.5 ± 9.1 years) with histopathologically confirmed NSCLC underwent F-FDG PET/CT followed by F-FDG PET/MRI in a single injection protocol. Two readers independently assessed T and N staging in separate sessions according to the seventh edition of the American Joint Committee on Cancer staging manual for F-FDG PET/CT and F-FDG PET/MRI, respectively. Histopathology as a reference standard was available for N staging in all 84 patients and for T staging in 39 patients. Differences in staging accuracy were assessed by McNemars chi test. The maximum standardized uptake value (SUV ) and longitudinal diameters of primary tumors were correlated using Pearson's coefficients. T stage was categorized concordantly in F-FDG PET/MRI and F-FDG PET/CT in 38 of 39 (97.4%) patients. Herein, F-FDG PET/CT and F-FDG PET/MRI correctly determined the T stage in 92.3 and 89.7% of patients, respectively. N stage was categorized concordantly in 83 of 84 patients (98.8%). F-FDG PET/CT correctly determined the N stage in 78 of 84 patients (92.9%), while F-FDG PET/MRI correctly determined the N stage in 77 of 84 patients (91.7%). Differences between F-FDG PET/CT and F-FDG PET/MRI in T and N staging accuracy were not statistically significant (p > 0.5, each). Tumor size and SUV measurements derived from both imaging modalities exhibited excellent correlation (r = 0.963 and r = 0.901, respectively). F-FDG PET/MRI and F-FDG PET/CT show an equivalently high diagnostic performance for T and N staging in patients suffering from NSCLC.