Paul Flechsig1, Christian M Zechmann2, Julian Schreiweis3, Clemens Kratochwil3, Daniel Rath3, Lawrence H Schwartz4, Heinz-Peter Schlemmer5, Hans-Ulrich Kauczor1, Uwe Haberkorn6, Frederik L Giesel7. 1. University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, INF 110, 69120 Heidelberg, Germany; German Cancer Research Center (dkfz), Clinical Cooperations Unit Nuclear Medicine, INF 280, 69120 Heidelberg, Germany. 2. University Hospital Heidelberg, Department of Nuclear Medicine, INF 400, 69120 Heidelberg, Germany; Rinecker Proton Therapy Center, Schäftlarnstraße 133, 81371 Munich, Germany. 3. University Hospital Heidelberg, Department of Nuclear Medicine, INF 400, 69120 Heidelberg, Germany. 4. Department of Radiology, Columbia University College of Physicians and Surgeons, USA; New York Presbyterian Hospital, 630 West 168th Street, New York, NY 10032, USA. 5. German Cancer Research Center (dkfz), Department of Radiology, INF 280, 69120 Heidelberg, Germany. 6. University Hospital Heidelberg, Department of Nuclear Medicine, INF 400, 69120 Heidelberg, Germany; German Cancer Research Center (dkfz), Clinical Cooperations Unit Nuclear Medicine, INF 280, 69120 Heidelberg, Germany. 7. University Hospital Heidelberg, Department of Nuclear Medicine, INF 400, 69120 Heidelberg, Germany; Department of Radiology, Columbia University College of Physicians and Surgeons, USA; New York Presbyterian Hospital, 630 West 168th Street, New York, NY 10032, USA; German Cancer Research Center (dkfz), Clinical Cooperations Unit Nuclear Medicine, INF 280, 69120 Heidelberg, Germany. Electronic address: frederik@egiesel.com.
Abstract
PURPOSE: To compare lesion conspicuity in patients with liver metastases arising from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) using MRI, PET and CT. MATERIALS AND METHODS: 16 patients with GEP-NETs were evaluated using non-contrast MRI, contrast-enhanced (CE) MRI using Gd-EOB-DTPA and CE-(68)Ga-DOTATOC PET. Quantitative analyses were performed by two blinded readers using ROI-analyses quantifying contrast ratios (CR) between normal liver-tissue and GEP-NET-metastases. Qualitative analyses were performed evaluating primary visibility and spatial detectability of all lesions. RESULTS: 103 of the same liver metastases were detected on all modalities. Qualitatively, lesion conspicuity was superior on CE-MRI imaging compared to non-contrast MR-sequences (T2, DWI, fl2D, fl3D), as well as arterial- and portal-venous phase CT. Concerning detectability of lesions, CE-MRI was superior to all other modalities. The quantitative ROI-analysis demonstrated improved CR for DWI compared to all other non-contrast MR-sequences (p<0.001). CE-MRI presented with higher CR-values compared to CE-(68)Ga-DOTATOC PET/CT (p<0.001). CONCLUSIONS: Anatomic imaging using non contrast MRI with fl2D-and fl3D-sequences in combination with the molecular imaging modality (68)Ga-DOTATOC PET is optimal for the assessment of liver lesions in GEP-NET-patients. Even though CE-MRI was superior to non-contrast MRI, non-contrast MRI is sufficient to detect and quantify liver metastases in daily routine, especially in combination with DW-Imaging.
PURPOSE: To compare lesion conspicuity in patients with liver metastases arising from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) using MRI, PET and CT. MATERIALS AND METHODS: 16 patients with GEP-NETs were evaluated using non-contrast MRI, contrast-enhanced (CE) MRI using Gd-EOB-DTPA and CE-(68)Ga-DOTATOC PET. Quantitative analyses were performed by two blinded readers using ROI-analyses quantifying contrast ratios (CR) between normal liver-tissue and GEP-NET-metastases. Qualitative analyses were performed evaluating primary visibility and spatial detectability of all lesions. RESULTS: 103 of the same liver metastases were detected on all modalities. Qualitatively, lesion conspicuity was superior on CE-MRI imaging compared to non-contrast MR-sequences (T2, DWI, fl2D, fl3D), as well as arterial- and portal-venous phase CT. Concerning detectability of lesions, CE-MRI was superior to all other modalities. The quantitative ROI-analysis demonstrated improved CR for DWI compared to all other non-contrast MR-sequences (p<0.001). CE-MRI presented with higher CR-values compared to CE-(68)Ga-DOTATOC PET/CT (p<0.001). CONCLUSIONS: Anatomic imaging using non contrast MRI with fl2D-and fl3D-sequences in combination with the molecular imaging modality (68)Ga-DOTATOC PET is optimal for the assessment of liver lesions in GEP-NET-patients. Even though CE-MRI was superior to non-contrast MRI, non-contrast MRI is sufficient to detect and quantify liver metastases in daily routine, especially in combination with DW-Imaging.
Authors: Paul Flechsig; Christina Walker; Clemens Kratochwil; Laila König; Andrei Iagura; Jan Moltz; Tim Holland-Letz; Hans-Ulrich Kauczor; Uwe Haberkorn; Frederik L Giesel Journal: Mol Imaging Biol Date: 2018-08 Impact factor: 3.488
Authors: Ali Pirasteh; Christopher Riedl; Marius Erik Mayerhoefer; Romina Grazia Giancipoli; Steven Mark Larson; Lisa Bodei Journal: Clin Transl Imaging Date: 2019-09-20
Authors: Katerina Deike-Hofmann; Daniel Thünemann; Michael O Breckwoldt; Daniel Schwarz; Alexander Radbruch; Alexander Enk; Martin Bendszus; Jessica Hassel; Heinz-Peter Schlemmer; Philipp Bäumer Journal: PLoS One Date: 2018-03-29 Impact factor: 3.240