1. Diagnostic performance of 18F-fluorodeoxyglucose-PET/MRI versus MRI alone in the diagnosis of pelvic recurrence of rectal cancer
- Author
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Michael Laniado, Jürgen Weitz, Heiner Nebelung, Ralf-Thorsten Hoffmann, Verena Plodeck, Jens-Peter Kühn, Christoph G Radosa, Sebastian Hoberück, Sophia Blum, Johannes Streitzig, Enrico Michler, Jörg Kotzerke, Ivan Platzek, Johannes Fritzmann, and Klaus Zöphel
- Subjects
Male ,medicine.medical_specialty ,Colorectal cancer ,Urology ,Sensitivity and Specificity ,Pelvis ,Fluorodeoxyglucose PET ,Recurrence ,Fluorodeoxyglucose F18 ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Rectal cancer ,Recurrent Rectal Cancer ,Retrospective Studies ,Radiological and Ultrasound Technology ,business.industry ,Rectal Neoplasms ,Gastroenterology ,Hepatology ,medicine.disease ,Magnetic Resonance Imaging ,Positron-Emission Tomography ,Histopathology ,Female ,18F-FDG-PET/MRI ,Neoplasm Recurrence, Local ,Radiopharmaceuticals ,business ,Nuclear medicine ,MRI - Abstract
Purpose To compare the diagnostic performance of 18F-fluorodeoxyglucose-PET/MRI and MRI in the diagnosis of pelvic recurrence of rectal cancer. Methods All PET/MRIs of patients in the follow-up of rectal cancer performed between 2011 and 2018 at our institution were retrospectively reviewed. Recurrence was confirmed/excluded either by histopathology or imaging follow-up (> 4 months). Four groups of readers (groups 1/2: one radiologist each, groups 3/4: one radiologist/one nuclear medicine physician) independently interpreted MRI and PET/MRI. The likelihood of recurrence was scored on a 5-point-scale. Inter-reader agreement, sensitivity, specificity, PPV/NPV and accuracy were assessed. ROC curve analyses were performed. Results Fourty-one PET/MRIs of 40 patients (mean 61 years ± 10.9; 11 women, 29 men) were included. Sensitivity of PET/MRI in detecting recurrence was 94%, specificity 88%, PPV/NPV 97% and 78%, accuracy 93%. Sensitivity of MRI was 88%, specificity 75%, PPV/NPV 94% and 60%, accuracy 85%. ROC curve analyses showed an AUC of 0.97 for PET/MRI and 0.92 for MRI, but the difference was not statistically significant (p = 0.116). On MRI more cases were scored as equivocal (12% versus 5%). Inter-reader agreement was substantial for PET/MRI and MRI (0.723 and 0.656, respectively). Conclusion 18F-FDG-PET/MRI and MRI are accurate in the diagnosis of locally recurrent rectal cancer. Sensitivity, specificity, PPV, NPV and accuracy are comparable for both modalities, but PET/MRI increases readers’ confidence levels and reduces the number of equivocal cases. Graphic abstract
- Published
- 2021