Diagnostic performance of fluorodeoxyglucose positron emission tomography/magnetic resonance imaging fusion images of gynecological malignant tumors: comparison with positron emission tomography/computed tomography.
OBJECTIVE
We compared the diagnostic accuracy of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and PET/magnetic resonance imaging (MRI) fusion images for gynecological malignancies.


METHODS
A total of 31 patients with gynecological malignancies were enrolled. FDG-PET images were fused to CT, T1- and T2-weighted images (T1WI, T2WI). PET-MRI fusion was performed semiautomatically. We performed three types of evaluation to demonstrate the usefulness of PET/MRI fusion images in comparison with that of inline PET/CT as follows: depiction of the uterus and the ovarian lesions on CT or MRI mapping images (first evaluation); additional information for lesion localization with PET and mapping images (second evaluation); and the image quality of fusion on interpretation (third evaluation).


RESULTS
For the first evaluation, the score for T2WI (4.68 +/- 0.65) was significantly higher than that for CT (3.54 +/- 1.02) or T1WI (3.71 +/- 0.97) (P < 0.01). For the second evaluation, the scores for the localization of FDG accumulation showing that T2WI (2.74 +/- 0.57) provided significantly more additional information for the identification of anatomical sites of FDG accumulation than did CT (2.06 +/- 0.68) or T1WI (2.23 +/- 0.61) (P < 0.01). For the third evaluation, the three-point rating scale for the patient group as a whole demonstrated that PET/T2WI (2.72 +/- 0.54) localized the lesion significantly more convincingly than PET/CT (2.23 +/- 0.50) or PET/T1WI (2.29 +/- 0.53) (P < 0.01).


CONCLUSIONS
PET/T2WI fusion images are superior for the detection and localization of gynecological malignancies.
Nakajo
Kazuya
K
Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Tatsumi
Mitsuaki
M
Inoue
Atsuo
A
Isohashi
Kayako
K
Higuchi
Ichiro
I
Kato
Hiroki
H
Imaizumi
Masao
M
Enomoto
Takayuki
T
Shimosegawa
Eku
E
Kimura
Tadashi
T
Hatazawa
Jun
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D016889:Endometrial Neoplasms / Q000175:diagnosis; D005260:Female; D019788:Fluorodeoxyglucose F18; D005833:Genital Neoplasms, Female / Q000175:diagnosis*; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D014599:Uterus / Q000473:pathology
D003287:Contrast Media; D019788:Fluorodeoxyglucose F18