Document Detail


Simulation of a MR-PET protocol for staging of head-and-neck cancer including Dixon MR for attenuation correction.
MedLine Citation:
PMID:  22078793     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To simulate and optimize a MR protocol for squamous cell cancer of the head and neck (HNSCC) patients for potential future use in an integrated whole-body MR-PET scanner. MATERIALS AND METHODS: On a clinical 3T scanner, which is the basis for a recently introduced fully integrated whole-body MR-PET, 20 patients with untreated HNSCC routinely staged with 18F-FDG PET/CT underwent a dedicated MR protocol for the neck. Moreover, a whole-body Dixon MR-sequence was applied, which is used for attenuation correction on a recently introduced hybrid MR-PET scanner. In a subset of patients volume-interpolated-breathhold (VIBE) T1w-sequences for lungs and liver were added. Total imaging time was analyzed for both groups. The quality of the delineation of the primary tumor (scale 0-3) and the presence or absence of lymph node metastases (scale 1-5) was evaluated for CT, MR, PET/CT and a combination of MR and PET to ensure that the MR-PET fusion does not cause a loss of diagnostic capability. PET was used to identify distant metastases. The PET dataset for simulated MR/PET was based on a segmentation of the CT data into 4 classes according to the approach of the Dixon MR-sequence for MR-PET. Standard of reference was histopathology in 19 cases. In one case no histopathological confirmation of a primary tumor could be achieved. RESULTS: Mean imaging time was 35:17min (range: 31:08-42:42min) for the protocol including sequences for local staging and attenuation correction and 44:17min (range: 35:44-54:58) for the extended protocol. Although not statistically significant a combination of MR and PET performed better in the delineation of the primary tumor (mean 2.20) compared to CT (mean 1.40), MR (1.95) and PET/CT (2.15) especially in patients with dental implants. PET/CT and combining MR and PET performed slightly better than CT and MR for the assessment of lymph node metastases. Two patients with distant metastases were only identified by PET. CONCLUSION: We established a potential MR-protocol to be used for HNSCC patients in a recently introduced MR-PET scanner. The proposed protocol can be performed in an acceptable time frame and did not lead to a loss of diagnostic capability compared to PET/CT.
Authors:
Matthias Eiber; Michael Souvatzoglou; Anja Pickhard; Denys J Loeffelbein; Andreas Knopf; Konstantin Holzapfel; Axel Martinez-Möller; Stephan G Nekolla; Elias Q Scherer; Markus Schwaiger; Ernst J Rummeny; Ambros J Beer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-10
Journal Detail:
Title:  European journal of radiology     Volume:  -     ISSN:  1872-7727     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
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