title: Diagnostic accuracy of dynamic gadoxetic-acid-enhanced MRI and PET/CT compared in patients with liver metastases from neuroendocrine neoplasms.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of dynamic-contrast-enhanced (DCE) MRI in comparison to both (18)F-FDG- and (68)Ga-DOTATATE-PET/CT in patients with liver metastases of neuroendocrine neoplasms (NEN).
  
  
  METHODS
  Thirty-two patients with hepatic metastases from NEN were examined both in DCE-MRI and positron emission tomography/computed tomography (PET/CT), using either (18)F-fluorodeoxyglucose ((18)F-FDG) or (68)Ga-DOTATATE as tracer. DCE-MRI was performed at 3 Tesla with Gd-EOB-DTPA acquiring 48 slices every 2.2 s for 5 min. Three regions of interest (ROIs) representing liver background and liver metastases were defined in fat-saturated T1w three-dimensional GRE MRI sequences in the hepatobiliary phase. Corresponding ROIs were then defined in the DCE-MRI- and in the PET/CT-dataset. Area under the curve (AUC) was calculated for the differentiation between metastases and liver background for DCE-MRI and PET-CT parameters.
  
  
  RESULTS
  AUC was very high for SUVmean (mean standardized uptake value) derived from (68)Ga-DOTATATE- (AUC = 0.966), and (18)F-FDG-PET/CT (AUC = 0.989). For DCE-MRI parameters, arterial flow fraction and intracellular uptake fraction showed the highest AUCs (AUC = 0.826, AUC = 0.819, respectively). The combination of those two had an AUC of 0.949. The combination of DCE-MRI and PET-CT parameters resulted in the highest AUC.
  
  
  CONCLUSIONS
  Both PET/CT parameters and DCE-MRI perfusion parameters show a high diagnostic accuracy in the distinction between liver metastases and liver tissue. Our data suggest that both modalities provide complementary information.
authors.affiliation: Department of Clinical Radiology, University Hospitals-Grosshadern, Ludwig-Maximilians University, Munich, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Armbruster
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Zech
authors.forename: Steven
authors.initials: S
authors.lastname: Sourbron
authors.forename: Felix
authors.initials: F
authors.lastname: Ceelen
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Auernhammer
authors.forename: Carsten
authors.initials: C
authors.lastname: Rist
authors.forename: Alexander
authors.initials: A
authors.lastname: Haug
authors.forename: Amit
authors.initials: A
authors.lastname: Singnurkar
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Wieland H
authors.initials: WH
authors.lastname: Sommer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D018358:Neuroendocrine Tumors / Q000175:diagnosis*; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C073590:gadolinium ethoxybenzyl DTPA; D019788:Fluorodeoxyglucose F18; C513399:gallium Ga 68 dotatate; D019786:Gadolinium DTPA
keywords: DCE-MRI; PET/CT; diagnostic accuracy; liver metastases; neuroendocrine tumor