Onofrio A Catalano1,2, Artur M Coutinho3, Dushyant V Sahani4, Mark G Vangel5, Michael S Gee4,6, Peter F Hahn4, Thomas Witzel7, Andrea Soricelli8, Marco Salvatore9, Ciprian Catana7, Umar Mahmood7,10, Bruce R Rosen7, Debra Gervais4. 1. Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA, 02129, USA. onofriocatalano@yahoo.it. 2. Department of Radiology, Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St, Boston, MA, 02114, USA. onofriocatalano@yahoo.it. 3. Department of Nuclear Medicine, University of São Paulo Medical School (FMUSP) and Hospital Sirio-Libanes, Sao Paulo, 01308-050, Brazil. 4. Department of Radiology, Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St, Boston, MA, 02114, USA. 5. Department of Radiology, MGH Biostatistics Center and MGH Martinos Center, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA, 02129, USA. 6. Department of Radiology, Pediatric Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA. 7. Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA, 02129, USA. 8. Department of Radiology, University of Naples Parthenope, Via F. Acton 38, 80143, Naples, Italy. 9. Department of Nuclear Medicine, SDN IRCCS, Via Gianturco 113, 80143, Naples, Italy. 10. Department of Radiology, Nuclear Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA.
Abstract
PURPOSE: Correct staging is imperative for colorectal cancer (CRC) since it influences both prognosis and management. Several imaging methods are used for this purpose, with variable performance. Positron emission tomography-magnetic resonance (PET/MR) is an innovative imaging technique recently employed for clinical application. The present study was undertaken to compare the staging accuracy of whole-body positron emission tomography-computed tomography (PET/CT) with whole-body PET/MR in patients with both newly diagnosed and treated colorectal cancer. METHODS: Twenty-six patients, who underwent same day whole-body (WB) PET/CT and WB-PET/MR, were evaluated. PET/CT and PET/MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Correct staging was compared between methods using McNemar's Chi square test. RESULTS: The two methods were in agreement and correct for 18/26 (69%) patients, and in agreement and incorrect for one patient (3.8%). PET/MR and PET/CT stages for the remaining 7/26 patients (27%) were discordant, with PET/MR staging being correct in all seven cases. PET/MR significantly outperformed PET/CT overall for accurate staging (P = 0.02). CONCLUSION: PET/MR outperformed PET/CT in CRC staging. PET/MR might allow accurate local and distant staging of CRC patients during both at the time of diagnosis and during follow-up.
PURPOSE: Correct staging is imperative for colorectal cancer (CRC) since it influences both prognosis and management. Several imaging methods are used for this purpose, with variable performance. Positron emission tomography-magnetic resonance (PET/MR) is an innovative imaging technique recently employed for clinical application. The present study was undertaken to compare the staging accuracy of whole-body positron emission tomography-computed tomography (PET/CT) with whole-body PET/MR in patients with both newly diagnosed and treated colorectal cancer. METHODS: Twenty-six patients, who underwent same day whole-body (WB) PET/CT and WB-PET/MR, were evaluated. PET/CT and PET/MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Correct staging was compared between methods using McNemar's Chi square test. RESULTS: The two methods were in agreement and correct for 18/26 (69%) patients, and in agreement and incorrect for one patient (3.8%). PET/MR and PET/CT stages for the remaining 7/26 patients (27%) were discordant, with PET/MR staging being correct in all seven cases. PET/MR significantly outperformed PET/CT overall for accurate staging (P = 0.02). CONCLUSION: PET/MR outperformed PET/CT in CRC staging. PET/MR might allow accurate local and distant staging of CRC patients during both at the time of diagnosis and during follow-up.
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