Abdominal and pelvic 18 F-FDG PET/MR: a review of current and emerging oncologic applications

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Abdominal and pelvic 18F‑FDG PET/MR: a review of current and emerging oncologic applications Ryan D. Ward1 · Barbara Amorim2 · Weier Li3 · Joseph King3 · Lale Umutlu4 · David Groshar5,6 · Mukesh Harisinghani3 · Onofrio Catalano3  Received: 29 June 2020 / Revised: 8 September 2020 / Accepted: 10 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Positron emission tomography (PET) using fluorodeoxyglucose (18F-FDG) combined with magnetic resonance imaging (MR) is an emerging hybrid modality that has shown utility in evaluating abdominal and pelvic disease entities. Together, the high soft tissue contrast and metabolic/functional imaging capabilities make this modality ideal for oncologic imaging in many organ systems. Its clinical utility continues to evolve and future research will help solidify its role in oncologic imaging. In this manuscript, we aim to (1) provide an overview of the various PET/MR systems, describing the strengths and weaknesses of each system, and (2) review the oncologic applications for 18F-FDG PET/MR in the abdomen and pelvis. Keywords  PET/MRI · PET/MR · Oncology · Staging · Cancer

Introduction and technical aspects of PET/ MR Introduction Positron emission tomography (PET) using fluorodeoxyglucose (18F-FDG) combined with magnetic resonance imaging (MR) is an emerging hybrid modality largely built on the success of conventional PET/CT which achieved rapid clinical adoption in the early 2000s [1, 2]. Though only

recently available in clinical practice, PET/MR harnesses the molecular imaging capabilities of PET and is combined with the high soft tissue and contrast resolution of conventional MR. In addition, multiparametric MR including diffusion, spectroscopy, and perfusion imaging add functional imaging capabilities which can be used to assess tissue cellularity, metabolite concentrations, and vascular permeability. A growing body of research suggests that this combination of anatomic and functional imaging is at least equivalent to and likely superior to CT, PET/CT, and conventional MR for

* Onofrio Catalano [email protected]

1



Cleveland Clinic, Department of Abdominal Imaging, 9500 Euclid Ave, L10, Cleveland, OH 44195, USA

Ryan D. Ward [email protected]

2



Division of Nuclear Medicine, University of Campinas, Rua Vital Brasil 251, Campinas, Brazil

Barbara Amorim [email protected]

3



Department of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA

4



Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany

5



Assuta Medical Center, Habrzel 20, 6971028 Tel‑Aviv, Israel

6



Sackler School of Medicine, Tel‑Aviv, Israel

Weier Li [email protected] Joseph King [email protected] Lale Umutlu Lale.Umutlu@uk‑essen.de David Groshar [email protected] Mukesh Harisinghani [email protected]

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Abdominal Radiology

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