PET/MR is a toss-up for thoracic staging of non-small cell lung cancer

Kathy Mahdoubi | | Health Imaging | Molecular Imaging

PET/MR doesn’t appear to provide any additional insight beyond PET/CT for thoracic staging of non-small cell lung cancer, according to a study published Feb. 6 in the Journal of Nuclear Medicine.

Philipp Heusch, MD, from the department of diagnostic and interventional radiology at the University of Dusseldorf, in Dusseldorf, Germany, and colleagues evaluated the two modalities with fluorodeoxyglucose (FDG) to see if PET/MR could scope out additional tumors or lymph node involvement with histopathology as a reference. Results of the study showed that, in fact, PET/MR performed very similarly to the standard and did not provide additional value. However, other kinds of applications within the realm of non-small cell lung cancer imaging could be better imaged with PET/MR.

“Although [whole body] F-18 FDG PET/CT provides a high rate in the detection of distant metastases, the use of a hybrid F-18 FDG PET/MR imaging might benefit distant metastases detection, because NSCLC metastases are mainly located in the brain, in the liver and in the bone,” wrote Heusch et al. “Because MR imaging offers advantages in lesion detection in those tissues, F-18 FDG PET/MR imaging is expected to yield higher detection rates than F-18 FDG PET/CT, whereas F-18 FDG PET/CT is expected to yield higher detection rates in small lung metastases and carcinomatous lymphangiosis.”

For this study, which was limited to thoracic staging, the researchers imaged 22 patients diagnosed with non-small cell lung cancer. Each underwent FDG PET/CT imaging and then FDG PET/MR imaging as well. The mean and maximum standardized uptake ratios were calculated and compared. Results revealed that both modalities correctly staged patients with non-small cell lung cancer at 100 percent for primary tumors and there was no statistically significant difference in imaging of lymph node involvement.

This study acts as a foundation for further studies to ascertain the benefit of PET/MR in other contexts of lung cancer imaging.

 

Kathy Mahdoubi

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