• European radiology · Aug 2014

    Whole-body [¹⁸F]FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results.

    • Karsten Beiderwellen, Michael Huebner, Philipp Heusch, Johannes Grueneisen, Verena Ruhlmann, Felix Nensa, Hilmar Kuehl, Lale Umutlu, Sandra Rosenbaum-Krumme, and Thomas C Lauenstein.
    • Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany, karsten.beiderwellen@uk-essen.de.
    • Eur Radiol. 2014 Aug 1; 24 (8): 2023-30.

    ObjectivesTo compare [(18)F]FDG PET/MRI with PET/CT for the assessment of bone lesions in oncologic patients.MethodsThis prospective study included 67 patients with solid tumours scheduled for PET/CT with [(18)F]FDG who also underwent a whole-body PET/MRI scan. The datasets (PET/CT, PET/MRI) were rated by two readers regarding lesion conspicuity (four-point scale) and diagnostic confidence (five-point scale). Median scores were compared using the Wilcoxon test.ResultsBone metastases were present in ten patients (15%), and benign bone lesions in 15 patients (22%). Bone metastases were predominantly localized in the pelvis (18 lesions, 38%) and the spine (14 lesions, 29%). Benign bone lesions were exclusively osteosclerotic and smaller than the metastases (mean size 6 mm vs. 23 mm). While PET/CT allowed identification of 45 of 48 bone metastases (94%), PET/MRI allowed identification of all bone metastases (100%). Conspicuity of metastases was high for both modalities with significantly better results using PET/MRI (p < 0.05). Diagnostic confidence in lesion detection was high for both modalities without a significant difference. In benign lesions, conspicuity and diagnostic confidence were significantly higher with PET/CT (p < 0.05).Conclusions[(18)F]FDG PET/MRI shows high potential for the assessment of bone metastases by offering superior lesion conspicuity when compared to PET/CT. In hypersclerotic, benign bone lesions PET/CT still sets the reference.Key Points• PET/MRI and PET/CT are of equal value for the identification of disease-positive patients • PET/MRI offers higher lesion conspicuity as well as diagnostic confidence • PET/MRI is an attractive new alternative for the assessment of bone metastases.

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