Simultaneous PET/MR head-neck cancer imaging: Preliminary clinical experience and multiparametric evaluation

M. Covello, C. Cavaliere, M. Aiello, M. S. Cianelli, M. Mesolella, B. Iorio, A. Rossi, E. Nicolai

Research output: Contribution to journalArticle

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Abstract

Abstract Purpose To evaluate the role of simultaneous hybrid PET/MR imaging and to correlate metabolic PET data with morpho-functional parameters derived by MRI in patients with head-neck cancer. Methods Forty-four patients, with histologically confirmed head and neck malignancy (22 primary tumors and 22 follow-up) were studied. Patients initially received a clinical exam and endoscopy with direct biopsy. Next patients underwent whole body PET/CT followed by PET/MR of the head/neck region. PET and MRI studies were separately evaluated by two blinded groups (both included one radiologist and one nuclear physician) in order to define the presence or absence of lesions/recurrences. Regions of interest (ROIs) analysis was conducted on the primary lesion at the level of maximum size on metabolic (SUV and MTV), diffusion (ADC) and perfusion (Ktrans, Ve, kep and iAUC) parameters. Results PET/MR examinations were successfully performed on all 44 patients. Agreement between the two blinded groups was found in anatomic allocation of lesions by PET/MR (Primary tumors: Cohen's kappa 0.93; Follow-up: Cohen's kappa 0.89). There was a significant correlation between CT-SUV measures and MR (e.g., CT-SUV VOI vs. MR-SUV VOI: ρ = 0.97, p <0.001 for the entire sample). There was also significant positive correlations between the ROI area, SUV measures, and the metabolic parameters (SUV and MTV) obtained during both PET/CT and PET/MR. A significant negative correlation was observed between ADC and Ktrans values in the primary tumors. In addition, a significant negative correlation existed between MR SUV and ADC in recurrent tumors. Conclusion Our study demonstrates the feasibility of PET/MR imaging for primary tumors and recurrent tumors evaluations of head/neck malignant lesions. When assessing HNC, PET/MR allows simultaneous collection of multiparametric metabolic and functional data. This technique therefore allows for a more complete characterization of malignant lesions.

Original languageEnglish
Article number7097
Pages (from-to)1269-1276
Number of pages8
JournalEuropean Journal of Radiology
Volume84
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

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Head and Neck Neoplasms
Neoplasms
Neck
Head
Feasibility Studies
Endoscopy
Perfusion
Physicians
Biopsy
Recurrence

Keywords

  • DCE
  • DWI
  • Head and neck cancer
  • Hybrid imaging
  • PET/MR
  • SUV

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Simultaneous PET/MR head-neck cancer imaging : Preliminary clinical experience and multiparametric evaluation. / Covello, M.; Cavaliere, C.; Aiello, M.; Cianelli, M. S.; Mesolella, M.; Iorio, B.; Rossi, A.; Nicolai, E.

In: European Journal of Radiology, Vol. 84, No. 7, 7097, 01.07.2015, p. 1269-1276.

Research output: Contribution to journalArticle

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abstract = "Abstract Purpose To evaluate the role of simultaneous hybrid PET/MR imaging and to correlate metabolic PET data with morpho-functional parameters derived by MRI in patients with head-neck cancer. Methods Forty-four patients, with histologically confirmed head and neck malignancy (22 primary tumors and 22 follow-up) were studied. Patients initially received a clinical exam and endoscopy with direct biopsy. Next patients underwent whole body PET/CT followed by PET/MR of the head/neck region. PET and MRI studies were separately evaluated by two blinded groups (both included one radiologist and one nuclear physician) in order to define the presence or absence of lesions/recurrences. Regions of interest (ROIs) analysis was conducted on the primary lesion at the level of maximum size on metabolic (SUV and MTV), diffusion (ADC) and perfusion (Ktrans, Ve, kep and iAUC) parameters. Results PET/MR examinations were successfully performed on all 44 patients. Agreement between the two blinded groups was found in anatomic allocation of lesions by PET/MR (Primary tumors: Cohen's kappa 0.93; Follow-up: Cohen's kappa 0.89). There was a significant correlation between CT-SUV measures and MR (e.g., CT-SUV VOI vs. MR-SUV VOI: ρ = 0.97, p <0.001 for the entire sample). There was also significant positive correlations between the ROI area, SUV measures, and the metabolic parameters (SUV and MTV) obtained during both PET/CT and PET/MR. A significant negative correlation was observed between ADC and Ktrans values in the primary tumors. In addition, a significant negative correlation existed between MR SUV and ADC in recurrent tumors. Conclusion Our study demonstrates the feasibility of PET/MR imaging for primary tumors and recurrent tumors evaluations of head/neck malignant lesions. When assessing HNC, PET/MR allows simultaneous collection of multiparametric metabolic and functional data. This technique therefore allows for a more complete characterization of malignant lesions.",
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AU - Cianelli, M. S.

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AU - Iorio, B.

AU - Rossi, A.

AU - Nicolai, E.

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KW - PET/MR

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