The usefulness of 18 F-FDG PET/MRI fusion image in diagnosing pancreatic tumor: comparison with 18 F-FDG PET/CT
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ORIGINAL ARTICLE
The usefulness of 18F-FDG PET/MRI fusion image in diagnosing pancreatic tumor: comparison with 18F-FDG PET/CT Shigeki Nagamachi • Ryuichi Nishii • Hideyuki Wakamatsu • Youichi Mizutani Shogo Kiyohara • Seigo Fujita • Shigemi Futami • Tatefumi Sakae • Eiji Furukoji • Shozo Tamura • Hideo Arita • Kazuo Chijiiwa • Keiichi Kawai
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Received: 19 September 2012 / Accepted: 17 March 2013 / Published online: 12 April 2013 Ó The Japanese Society of Nuclear Medicine 2013
Abstract Purpose This study aimed at demonstrating the feasibility of retrospectively fused 18F FDG-PET and MRI (PET/MRI fusion image) in diagnosing pancreatic tumor, in particular differentiating malignant tumor from benign lesions. In addition, we evaluated additional findings characterizing pancreatic lesions by FDG-PET/MRI fusion image. Methods We analyzed retrospectively 119 patients: 96 cancers and 23 benign lesions. FDG-PET/MRI fusion images (PET/T1 WI or PET/T2WI) were made by dedicated software using 1.5 Tesla (T) MRI image and FDGPET images. These images were interpreted by two welltrained radiologists without knowledge of clinical information and compared with FDG-PET/CT images. We compared the differential diagnostic capability between PET/CT and FDG-PET/MRI fusion image. In addition, we evaluated additional findings such as tumor structure and tumor invasion. Results FDG-PET/MRI fusion image significantly improved accuracy compared with that of PET/CT (96.6
vs. 86.6 %). As additional finding, dilatation of main pancreatic duct was noted in 65.9 % of solid types and in 22.6 % of cystic types, on PET/MRI-T2 fusion image. Similarly, encasement of adjacent vessels was noted in 43.1 % of solid types and in 6.5 % of cystic types. Particularly in cystic types, intra-tumor structures such as mural nodule (35.4 %) or intra-cystic septum (74.2 %) were detected additionally. Besides, PET/MRI-T2 fusion image could detect extra benign cystic lesions (9.1 % in solid type and 9.7 % in cystic type) that were not noted by PET/CT. Conclusions In diagnosing pancreatic lesions, FDG-PET/ MRI fusion image was useful in differentiating pancreatic cancer from benign lesions. Furthermore, it was helpful in evaluating relationship between lesions and surrounding tissues as well as in detecting extra benign cysts. Keywords 18F FDG-PET/CT 18F FDG-PET/MRI fusion image Pancreatic tumor
Introduction S. Nagamachi (&) R. Nishii H. Wakamatsu Y. Mizutani S. Kiyohara S. Fujita S. Futami T. Sakae E. Furukoji S. Tamura H. Arita Department of Radiology, School of Medicine, Miyazaki University, 5200 Kihara, Kiyotake, Miyazaki-city, Miyazaki Prefecture 889-1692, Japan e-mail: [email protected] K. Chijiiwa Department of the 1st Surgery, Faculty of Medicine, Miyazaki University, 5200 Kihara, Kiyotake, Miyazaki-city, Miyazaki Prefecture 889-1692, Japan K. Kawai Faculty of Health Science, School of Medicine, Kanazawa University, Kanazawa, Ishikawa Prefecture 920-8640, Japan
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F-fluorodeoxyglucose (FDG)-positron emission tomogra
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