Diagnostic performance of prospective same-day 18F-FDG PET/MRI and 18F-FDG PET/CT in the staging and response assessment of lymphoma.


Journal

Cancer imaging : the official publication of the International Cancer Imaging Society
ISSN: 1470-7330
Titre abrégé: Cancer Imaging
Pays: England
ID NLM: 101172931

Informations de publication

Date de publication:
24 Jan 2023
Historique:
received: 22 08 2022
accepted: 03 01 2023
entrez: 24 1 2023
pubmed: 25 1 2023
medline: 27 1 2023
Statut: epublish

Résumé

Accurate staging and response assessment are essential for prognosis and to guide treatment in patients with lymphoma. The aim of this study was to compare the diagnostic performance of FDG PET/MRI versus FDG PET/CT in adult patients with newly diagnosed Hodgkin and Non- Hodgkin lymphoma. In this single centre study, 50 patients were prospectively recruited. FDG PET/MRI was performed after staging FDG PET/CT using a single injection of 18F-FDG. Patients were invited to complete same-day FDG PET/MRI with FDG PET/CT at interim and end of treatment response assessments. Performance was assessed using PET/CT as the reference standard for disease site identification, staging, response assessment with Deauville score and concordance in metabolic activity. Staging assessment showed perfect agreement (κ = 1.0, P = 0) between PET/MRI and PET/CT using Ann Arbor staging. There was excellent intermodality correlation with disease site identification at staging (κ = 0.976, P < 0.001) with FDG PET/MRI sensitivity of 96% (95% CI, 94-98%) and specificity of 100% (95% CI, 99-100%). There was good correlation of disease site identification at interim assessment (κ = 0.819, P < 0.001) and excellent correlation at end-of-treatment assessment (κ = 1.0, P < 0.001). Intermodality agreement for Deauville scores was good at interim assessment (κ = 0.808, P < 0.001) and excellent at end-of-treatment assessment (κ = 1.0, P = 0). There was good-excellent concordance in SUV max and mean between modalities across timepoints. Minimum calculated radiation patient effective dose saving was 54% between the two modalities per scan. With high concordance in disease site identification, staging and response assessment, PET/MR is a potentially viable alternative to PET/CT in lymphoma that minimises radiation exposure.

Sections du résumé

BACKGROUND BACKGROUND
Accurate staging and response assessment are essential for prognosis and to guide treatment in patients with lymphoma. The aim of this study was to compare the diagnostic performance of FDG PET/MRI versus FDG PET/CT in adult patients with newly diagnosed Hodgkin and Non- Hodgkin lymphoma.
METHODS METHODS
In this single centre study, 50 patients were prospectively recruited. FDG PET/MRI was performed after staging FDG PET/CT using a single injection of 18F-FDG. Patients were invited to complete same-day FDG PET/MRI with FDG PET/CT at interim and end of treatment response assessments. Performance was assessed using PET/CT as the reference standard for disease site identification, staging, response assessment with Deauville score and concordance in metabolic activity.
RESULTS RESULTS
Staging assessment showed perfect agreement (κ = 1.0, P = 0) between PET/MRI and PET/CT using Ann Arbor staging. There was excellent intermodality correlation with disease site identification at staging (κ = 0.976, P < 0.001) with FDG PET/MRI sensitivity of 96% (95% CI, 94-98%) and specificity of 100% (95% CI, 99-100%). There was good correlation of disease site identification at interim assessment (κ = 0.819, P < 0.001) and excellent correlation at end-of-treatment assessment (κ = 1.0, P < 0.001). Intermodality agreement for Deauville scores was good at interim assessment (κ = 0.808, P < 0.001) and excellent at end-of-treatment assessment (κ = 1.0, P = 0). There was good-excellent concordance in SUV max and mean between modalities across timepoints. Minimum calculated radiation patient effective dose saving was 54% between the two modalities per scan.
CONCLUSION CONCLUSIONS
With high concordance in disease site identification, staging and response assessment, PET/MR is a potentially viable alternative to PET/CT in lymphoma that minimises radiation exposure.

Identifiants

pubmed: 36694244
doi: 10.1186/s40644-023-00520-7
pii: 10.1186/s40644-023-00520-7
pmc: PMC9872391
doi:

Substances chimiques

Fluorodeoxyglucose F18 0Z5B2CJX4D
Radiopharmaceuticals 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

11

Informations de copyright

© 2023. The Author(s).

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Auteurs

Vijay Mistry (V)

Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia. vjmis3@gmail.com.

Justin R Scott (JR)

QCIF Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia.

Tzu-Yang Wang (TY)

Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia.

Peter Mollee (P)

Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia.
Translational Research Institute, Princess Alexandra Hospital, Brisbane, Australia.

Kenneth A Miles (KA)

Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia.
Institute of Nuclear Medicine, University College London, University College Hospital, London, UK.

W Phillip Law (WP)

Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia.
Translational Research Institute, Princess Alexandra Hospital, Brisbane, Australia.
School of Medicine, University of Queensland, Brisbane, Australia.

Greg Hapgood (G)

Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia.
Translational Research Institute, Princess Alexandra Hospital, Brisbane, Australia.

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Classifications MeSH