title: Simultaneous PET/MR head-neck cancer imaging: Preliminary clinical experience and multiparametric evaluation.
abstract: OBJECTIVE
  To evaluate the role of simultaneous hybrid PET/MR imaging and to correlate metabolic PET data with morpho-functional parameters derived by MRI in patients with head-neck cancer.
  
  
  METHODS
  Forty-four patients, with histologically confirmed head and neck malignancy (22 primary tumors and 22 follow-up) were studied. Patients initially received a clinical exam and endoscopy with direct biopsy. Next patients underwent whole body PET/CT followed by PET/MR of the head/neck region. PET and MRI studies were separately evaluated by two blinded groups (both included one radiologist and one nuclear physician) in order to define the presence or absence of lesions/recurrences. Regions of interest (ROIs) analysis was conducted on the primary lesion at the level of maximum size on metabolic (SUV and MTV), diffusion (ADC) and perfusion (K(trans), Ve, kep and iAUC) parameters.
  
  
  RESULTS
  PET/MR examinations were successfully performed on all 44 patients. Agreement between the two blinded groups was found in anatomic allocation of lesions by PET/MR (Primary tumors: Cohen's kappa 0.93;
  
  
  RESULTS
  Cohen's kappa 0.89). There was a significant correlation between CT-SUV measures and MR (e.g., CT-SUV VOI vs.
  ρ=0.97, p<0.001 for the entire sample). There was also significant positive correlations between the ROI area, SUV measures, and the metabolic parameters (SUV and MTV) obtained during both PET/CT and PET/MR. A significant negative correlation was observed between ADC and K(trans) values in the primary tumors. In addition, a significant negative correlation existed between MR SUV and ADC in recurrent tumors.
  
  
  CONCLUSIONS
  Our study demonstrates the feasibility of PET/MR imaging for primary tumors and recurrent tumors evaluations of head/neck malignant lesions. When assessing HNC, PET/MR allows simultaneous collection of multiparametric metabolic and functional data. This technique therefore allows for a more complete characterization of malignant lesions.
authors.affiliation: IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy. Electronic address: echoplanare@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Covello
authors.affiliation: IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cavaliere
authors.affiliation: IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Aiello
authors.affiliation: IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy.
authors.forename: M S
authors.initials: MS
authors.lastname: Cianelli
authors.affiliation: Department of Otorhinolaryngoiatry, Federico II University, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mesolella
authors.affiliation: Department of Otorhinolaryngoiatry, Federico II University, Naples, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Iorio
authors.affiliation: IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.affiliation: IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Nicolai
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: DCE; DWI; Head and neck cancer; Hybrid imaging; PET/MR; SUV