Maryam Aghighi1, Laura Jean Pisani1, Ziyan Sun1, Christopher Klenk1, Himani Madnawat1, Sandra Luna Fineman2, Ranjana Advani3, Rie Von Eyben4, Daniel Owen1, Andrew Quon1, Michael Moseley1, Heike E Daldrup-Link5. 1. Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA. 2. Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA. 3. Department of Medicine, Stanford Hospital, Stanford University, Stanford, CA, USA. 4. Department of Radiation and Oncology, Stanford University, Stanford, CA, USA. 5. Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA. heiked@stanford.edu.
Abstract
OBJECTIVE: Combining 18F-FDG PET with whole-body MR for paediatric cancer staging is practically feasible if imaging protocols can be streamlined. We compared 18F-FDG PET/STIR with accelerated 18F-FDG PET/FSPGR for whole-body tumour imaging in children and young adults. METHODS: Thirty-three children and young adults (17.5 ± 5.5 years, range 10-30) with malignant lymphoma or sarcoma underwent a 18F-FDG PET staging examination, followed by ferumoxytol-enhanced STIR and FSPGR whole-body MR. 18F-FDG PET scans were fused with MR data and the number and location of tumours on each integrated examination were determined. Histopathology and follow-up imaging served as standard of reference. The agreement of each MR sequence with the reference and whole-body imaging times were compared using Cohen's kappa coefficient and Student's t-test, respectively. RESULTS: Comparing 18F-FDG PET/FSPGR to 18F-FDG PET/STIR, sensitivities were 99.3 % for both, specificities were statistically equivalent, 99.8 versus 99.9 %, and the agreement with the reference based on Cohen's kappa coefficient was also statistically equivalent, 0.989 versus 0.992. However, the total scan-time for accelerated FSPGR of 19.8 ± 5.3 minutes was significantly shorter compared to 29.0 ± 7.6 minutes for STIR (p = 0.001). CONCLUSION: F-FDG PET/FSPGR demonstrated equivalent sensitivities and specificities for cancer staging compared to 18F-FDG PET/STIR, but could be acquired with shorter acquisition time. KEY POINTS: • Breath-hold FSPGR sequences shorten the data acquisition time for whole-body MR and PET/MR. • Ferumoxytol provides long-lasting vascular contrast for whole-body MR and PET/MR. • 18 F-FDG PET/FSPGR data provided equal sensitivity and specificity for cancer staging compared to 18 F-FDG PET/STIR.
OBJECTIVE: Combining 18F-FDG PET with whole-body MR for paediatric cancer staging is practically feasible if imaging protocols can be streamlined. We compared 18F-FDG PET/STIR with accelerated 18F-FDG PET/FSPGR for whole-body tumour imaging in children and young adults. METHODS: Thirty-three children and young adults (17.5 ± 5.5 years, range 10-30) with malignant lymphoma or sarcoma underwent a 18F-FDG PET staging examination, followed by ferumoxytol-enhanced STIR and FSPGR whole-body MR. 18F-FDG PET scans were fused with MR data and the number and location of tumours on each integrated examination were determined. Histopathology and follow-up imaging served as standard of reference. The agreement of each MR sequence with the reference and whole-body imaging times were compared using Cohen's kappa coefficient and Student's t-test, respectively. RESULTS: Comparing 18F-FDG PET/FSPGR to 18F-FDG PET/STIR, sensitivities were 99.3 % for both, specificities were statistically equivalent, 99.8 versus 99.9 %, and the agreement with the reference based on Cohen's kappa coefficient was also statistically equivalent, 0.989 versus 0.992. However, the total scan-time for accelerated FSPGR of 19.8 ± 5.3 minutes was significantly shorter compared to 29.0 ± 7.6 minutes for STIR (p = 0.001). CONCLUSION: F-FDG PET/FSPGR demonstrated equivalent sensitivities and specificities for cancer staging compared to 18F-FDG PET/STIR, but could be acquired with shorter acquisition time. KEY POINTS: • Breath-hold FSPGR sequences shorten the data acquisition time for whole-body MR and PET/MR. • Ferumoxytol provides long-lasting vascular contrast for whole-body MR and PET/MR. • 18 F-FDG PET/FSPGR data provided equal sensitivity and specificity for cancer staging compared to 18 F-FDG PET/STIR.
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Authors: Gerda B Toth; Csanad G Varallyay; Andrea Horvath; Mustafa R Bashir; Peter L Choyke; Heike E Daldrup-Link; Edit Dosa; John Paul Finn; Seymur Gahramanov; Mukesh Harisinghani; Iain Macdougall; Alexander Neuwelt; Shreyas S Vasanawala; Prakash Ambady; Ramon Barajas; Justin S Cetas; Jeremy Ciporen; Thomas J DeLoughery; Nancy D Doolittle; Rongwei Fu; John Grinstead; Alexander R Guimaraes; Bronwyn E Hamilton; Xin Li; Heather L McConnell; Leslie L Muldoon; Gary Nesbit; Joao P Netto; David Petterson; William D Rooney; Daniel Schwartz; Laszlo Szidonya; Edward A Neuwelt Journal: Kidney Int Date: 2017-04-20 Impact factor: 10.612
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