Pierpaolo Biondetti1, Mark G Vangel2, Rita M Lahoud1, Felipe S Furtado1, Bruce R Rosen1,3, David Groshar4,5, Lina G Canamaque6, Lale Umutlu7, Eric W Zhang1, Umar Mahmood1,3, Subba R Digumarthy1, Jo-Anne O Shepard1, Onofrio A Catalano8,9. 1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA. 2. Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, 60 Staniford St, Boston, MA, USA. 3. Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 4. Department of Nuclear Medicine, Assuta Medical Centers, Tel Aviv, Israel. 5. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 6. Department of Nuclear Medicine. Grupo HM Hospitales, Madrid, Spain. 7. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany. 8. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA. ocatalano@mgh.harvard.edu. 9. Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. ocatalano@mgh.harvard.edu.
Abstract
PURPOSE: To evaluate PET/MR lung nodule detection compared to PET/CT or CT, to determine growth of nodules missed by PET/MR, and to investigate the impact of missed nodules on clinical management in primary abdominal malignancies. METHODS: This retrospective IRB-approved study included [18F]-FDG PET/MR in 126 patients. All had standard of care chest imaging (SCI) with diagnostic chest CT or PET/CT within 6 weeks of PET/MR that served as standard of reference. Two radiologists assessed lung nodules (size, location, consistency, position, and [18F]-FDG avidity) on SCI and PET/MR. A side-by-side analysis of nodules on SCI and PET/MR was performed. The nodules missed on PET/MR were assessed on follow-up SCI to ascertain their growth (≥ 2 mm); their impact on management was also investigated. RESULTS: A total of 505 nodules (mean 4 mm, range 1-23 mm) were detected by SCI in 89/126 patients (66M:60F, mean age 60 years). PET/MR detected 61 nodules for a sensitivity of 28.1% for patient and 12.1% for nodule, with higher sensitivity for > 7 mm nodules (< 30% and > 70% respectively, p < 0.05). 75/337 (22.3%) of the nodules missed on PET/MR (follow-up mean 736 days) demonstrated growth. In patients positive for nodules at SCI and negative at PET/MR, missed nodules did not influence patients' management. CONCLUSIONS: Sensitivity of lung nodule detection on PET/MR is affected by nodule size and is lower than SCI. 22.3% of missed nodules increased on follow-up likely representing metastases. Although this did not impact clinical management in study group with primary abdominal malignancy, largely composed of extra-thoracic advanced stage cancers, with possible different implications in patients without extra-thoracic spread.
PURPOSE: To evaluate PET/MR lung nodule detection compared to PET/CT or CT, to determine growth of nodules missed by PET/MR, and to investigate the impact of missed nodules on clinical management in primary abdominal malignancies. METHODS: This retrospective IRB-approved study included [18F]-FDG PET/MR in 126 patients. All had standard of care chest imaging (SCI) with diagnostic chest CT or PET/CT within 6 weeks of PET/MR that served as standard of reference. Two radiologists assessed lung nodules (size, location, consistency, position, and [18F]-FDG avidity) on SCI and PET/MR. A side-by-side analysis of nodules on SCI and PET/MR was performed. The nodules missed on PET/MR were assessed on follow-up SCI to ascertain their growth (≥ 2 mm); their impact on management was also investigated. RESULTS: A total of 505 nodules (mean 4 mm, range 1-23 mm) were detected by SCI in 89/126 patients (66M:60F, mean age 60 years). PET/MR detected 61 nodules for a sensitivity of 28.1% for patient and 12.1% for nodule, with higher sensitivity for > 7 mm nodules (< 30% and > 70% respectively, p < 0.05). 75/337 (22.3%) of the nodules missed on PET/MR (follow-up mean 736 days) demonstrated growth. In patients positive for nodules at SCI and negative at PET/MR, missed nodules did not influence patients' management. CONCLUSIONS: Sensitivity of lung nodule detection on PET/MR is affected by nodule size and is lower than SCI. 22.3% of missed nodules increased on follow-up likely representing metastases. Although this did not impact clinical management in study group with primary abdominal malignancy, largely composed of extra-thoracic advanced stage cancers, with possible different implications in patients without extra-thoracic spread.
Authors: Michael K Gould; Tania Tang; In-Lu Amy Liu; Janet Lee; Chengyi Zheng; Kim N Danforth; Anne E Kosco; Jamie L Di Fiore; David E Suh Journal: Am J Respir Crit Care Med Date: 2015-11-15 Impact factor: 21.405
Authors: Ivo Rausch; Harald H Quick; Jacobo Cal-Gonzalez; Bernhard Sattler; Ronald Boellaard; Thomas Beyer Journal: Eur J Radiol Date: 2017-04-08 Impact factor: 3.528
Authors: Onofrio A Catalano; Bruce R Rosen; Dushyant V Sahani; Peter F Hahn; Alexander R Guimaraes; Mark G Vangel; Emanuele Nicolai; Andrea Soricelli; Marco Salvatore Journal: Radiology Date: 2013-10-28 Impact factor: 11.105
Authors: Barbara J Amorim; Theodore S Hong; Lawrence S Blaszkowsky; Cristina R Ferrone; David L Berger; Liliana G Bordeianou; Rocco Ricciardi; Jeffrey W Clark; David P Ryan; Jennifer Y Wo; Motaz Qadan; Mark Vangel; Lale Umutlu; David Groshar; Lina G Cañamaques; Debra A Gervais; Umar Mahmood; Bruce R Rosen; Onofrio A Catalano Journal: Eur J Nucl Med Mol Imaging Date: 2019-07-29 Impact factor: 9.236
Authors: Alexander Herold; Christian Wassipaul; Michael Weber; Florian Lindenlaub; Sazan Rasul; Anton Stift; Judith Stift; Marius E Mayerhoefer; Marcus Hacker; Ahmed Ba-Ssalamah; Alexander R Haug; Dietmar Tamandl Journal: Eur J Nucl Med Mol Imaging Date: 2022-09-05 Impact factor: 10.057
Authors: Nils Martin Bruckmann; Julian Kirchner; Janna Morawitz; Lale Umutlu; Wolfgang P Fendler; Ken Herrmann; Ann-Kathrin Bittner; Oliver Hoffmann; Tanja Fehm; Maike E Lindemann; Christian Buchbender; Gerald Antoch; Lino M Sawicki Journal: EJNMMI Phys Date: 2022-02-07
Authors: Kai Jannusch; Nils Martin Bruckmann; Charlotte Johanna Geuting; Janna Morawitz; Frederic Dietzel; Christoph Rischpler; Ken Herrmann; Ann-Kathrin Bittner; Oliver Hoffmann; Svjetlana Mohrmann; Harald H Quick; Lale Umutlu; Gerald Antoch; Julian Kirchner Journal: Cancers (Basel) Date: 2022-07-15 Impact factor: 6.575
Authors: Felipe S Furtado; Krista E Suarez-Weiss; Mark Vangel; Jeffrey W Clark; James C Cusack; Theodore Hong; Lawrence Blaszkowsky; Jennifer Wo; Robin Striar; Lale Umutlu; Heike E Daldrup-Link; David Groshar; Ricciardi Rocco; Liliana Bordeianou; Mark A Anderson; Amirkasra Mojtahed; Motaz Qadan; Cristina Ferrone; Onofrio A Catalano Journal: Br J Cancer Date: 2021-07-19 Impact factor: 9.075