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KMID : 1148920160500030228
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Nuclear Medicine and Molecular Imaging
2016 Volume.50 No. 3 p.228 ~ p.239
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Conspicuity of FDG-Avid Osseous Lesions on PET/MRI Versus PET/CT: a Quantitative and Visual Analysis
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Fraum Tyler J.
Fowler Kathryn J.
McConathy Jonathan
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Abstract
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Background: Because standard MRI-based attenuation correction (AC) does not account for the attenuation of photons by cortical bone, PET/MRI may have reduced sensitivity for FDG-avid focal bone lesions (FFBLs). This study evaluates whether MRI-based AC compromises detection of FFBLs, by comparing their conspicuity both quantitatively and qualitatively on PET/MRI versus PET/CT.
Methods: One hundred ninety general oncology patients underwent whole-body PET/CT followed by whole-body PET/MRI, utilizing the same FDG dose. Thirteen patients with a total of 50 FFBLs were identified. Using automated contouring software, a volumetric contour was generated for each FFBL. Adjacent regions of normal background bone (BB) were selected manually. For each contour, SUV-max and SUV-mean were determined. Lesion-to-background SUV ratios served as quantitative metrics of conspicuity. Additionally, two blinded readers evaluated the relative conspicuity of FFBLs on PET images derived from MRI-based AC versus CT-based AC. Visibility of an anatomic correlate for FFBLs on the corresponding CT and MR images was also assessed.
Results: SUV-mean was lower on PET/MRI for both FFBLs (-6.5 %, p?=?0.009) and BB (-20.5 %, p?
Conclusions: Both FFBLs and BB had lower mean SUVs on PET/MRI than PET/CT. This finding was likely in part due to differences in the handling of cortical bone by MRI-based AC versus CT-based AC. Despite this systematic bias, FFBLs had greater conspicuity on PET/MRI, both qualitatively and quantitatively. This difference was likely due to the longer tracer uptake times for PET/MRI, which allowed for more tracer accumulation by FFBLs and more tracer washout from BB. Our results suggest that whole-body PET/MRI and PET/CT provide comparable sensitivity for detection of FDG-avid focal bone lesions.
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KEYWORD
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Clinical oncology, Magnetic resonance imaging, Multimodal imaging, Positron emission tomography, Whole-body imaging
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