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Pugmire BS, Guimaraes AR, Lim R, et al. Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography. World J Radiol. 2016;8(3):322-30doi: 10.4329/wjr.v8.i3.322.
Pugmire, B. S., Guimaraes, A. R., Lim, R., Friedmann, A. M., Huang, M., Ebb, D., Weinstein, H., Catalano, O. A., Mahmood, U., Catana, C., & Gee, M. S. (2016). Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography. World journal of radiology, 8(3), 322-30. https://doi.org/10.4329/wjr.v8.i3.322
Pugmire, Brian S, et al. "Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography." World journal of radiology vol. 8,3 (2016): 322-30. doi: https://doi.org/10.4329/wjr.v8.i3.322
Pugmire BS, Guimaraes AR, Lim R, Friedmann AM, Huang M, Ebb D, Weinstein H, Catalano OA, Mahmood U, Catana C, Gee MS. Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography. World J Radiol. 2016 Mar 28;8(3):322-30. doi: 10.4329/wjr.v8.i3.322. PMID: 27028112; PMCID: PMC4807342.
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World J Radiol. 2016 Mar 28;8(3):322-30. doi: 10.4329/wjr.v8.i3.322.

Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography.

World journal of radiology

Brian S Pugmire, Alexander R Guimaraes, Ruth Lim, Alison M Friedmann, Mary Huang, David Ebb, Howard Weinstein, Onofrio A Catalano, Umar Mahmood, Ciprian Catana, Michael S Gee

Affiliations

  1. Brian S Pugmire, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States.

PMID: 27028112 PMCID: PMC4807342 DOI: 10.4329/wjr.v8.i3.322

Abstract

AIM: To describe our preliminary experience with simultaneous whole body (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients.

METHODS: This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated (18)F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard.

RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was significantly lower than that of benign lesions (1246.2 + 417.3; P = 0.0003; Student's t test). A range of ADCmin thresholds for malignancy were evaluated, from 0.5-1.5 × 10(-3) mm(2)/s. The 1.0 × 10(-3) ADCmin threshold performed best compared with PET-CT reference (68.3% accuracy). However, the accuracy of PET-MRI SUVmax was significantly better than ADCmin for detecting malignant lesions compared with PET-CT reference (P < 0.0001; two-tailed McNemar's test).

CONCLUSION: These results suggest a clinical role for simultaneous whole body PET-MRI in evaluating pediatric cancer patients.

Keywords: Cancer; Magnetic resonance imaging; Oncology; Pediatric imaging; Positron emission tomography; Radiology

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