title: Whole-body [¹⁸F]FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results.
abstract: OBJECTIVE
  To compare [(18)F]FDG PET/MRI with PET/CT for the assessment of bone lesions in oncologic patients.
  
  
  METHODS
  This prospective study included 67 patients with solid tumours scheduled for PET/CT with [(18)F]FDG who also underwent a whole-body PET/MRI scan. The datasets (PET/CT, PET/MRI) were rated by two readers regarding lesion conspicuity (four-point scale) and diagnostic confidence (five-point scale). Median scores were compared using the Wilcoxon test.
  
  
  RESULTS
  Bone metastases were present in ten patients (15%), and benign bone lesions in 15 patients (22%). Bone metastases were predominantly localized in the pelvis (18 lesions, 38%) and the spine (14 lesions, 29%). Benign bone lesions were exclusively osteosclerotic and smaller than the metastases (mean size 6 mm vs. 23 mm). While PET/CT allowed identification of 45 of 48 bone metastases (94%), PET/MRI allowed identification of all bone metastases (100%). Conspicuity of metastases was high for both modalities with significantly better results using PET/MRI (p < 0.05). Diagnostic confidence in lesion detection was high for both modalities without a significant difference. In benign lesions, conspicuity and diagnostic confidence were significantly higher with PET/CT (p < 0.05).
  
  
  CONCLUSIONS
  [(18)F]FDG PET/MRI shows high potential for the assessment of bone metastases by offering superior lesion conspicuity when compared to PET/CT. In hypersclerotic, benign bone lesions PET/CT still sets the reference.
  
  
  CONCLUSIONS
  • PET/MRI and PET/CT are of equal value for the identification of disease-positive patients • PET/MRI offers higher lesion conspicuity as well as diagnostic confidence • PET/MRI is an attractive new alternative for the assessment of bone metastases.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany, karsten.beiderwellen@uk-essen.de.
authors.forename: Karsten
authors.initials: K
authors.lastname: Beiderwellen
authors.forename: Michael
authors.initials: M
authors.lastname: Huebner
authors.forename: Philipp
authors.initials: P
authors.lastname: Heusch
authors.forename: Johannes
authors.initials: J
authors.lastname: Grueneisen
authors.forename: Verena
authors.initials: V
authors.lastname: Ruhlmann
authors.forename: Felix
authors.initials: F
authors.lastname: Nensa
authors.forename: Hilmar
authors.initials: H
authors.lastname: Kuehl
authors.forename: Lale
authors.initials: L
authors.lastname: Umutlu
authors.forename: Sandra
authors.initials: S
authors.lastname: Rosenbaum-Krumme
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Lauenstein
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18