title: PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of PET/MRI and PET/CT for staging and re-staging advanced gynaecological cancer patients as well as identify the potential benefits of each method in such a population.
  
  
  METHODS
  Twenty-six patients with suspicious or proven advanced gynaecological cancer (12 ovarian, seven cervical, one vulvar and four endometrial tumours, one uterine metastasis, and one primary peritoneal cancer) underwent whole-body imaging with a sequential trimodality PET/CT/MR system. Images were analysed regarding primary tumour detection and delineation, loco-regional lymph node staging, and abdominal/extra-abdominal distant metastasis detection (last only by PET/CT).
  
  
  RESULTS
  Eighteen (69.2 %) patients underwent PET/MRI for primary staging and eight patients (30.8 %) for re-staging their gynaecological malignancies. For primary tumour delineation, PET/MRI accuracy was statistically superior to PET/CT (p < 0.001). Among the different types of cancer, PET/MRI presented better tumour delineation mainly for cervical (6/7) and endometrial (2/3) cancers. PET/MRI for local evaluation as well as PET/CT for extra-abdominal metastases had therapeutic consequences in three and one patients, respectively. PET/CT detected 12 extra-abdominal distant metastases in 26 patients.
  
  
  CONCLUSIONS
  PET/MRI is superior to PET/CT for primary tumour delineation. No differences were found in detection of regional lymph node involvement and abdominal metastases detection.
  
  
  CONCLUSIONS
  • PET/MRI is superior to PET/CT for primary tumour delineation • PET/CT represents a reliable tool to detect extra-abdominal distant metastasis • PET/MRI might be the preferred imaging modality for staging cervical and endometrial tumours • Whole-body staging for detection and evaluation of extra-abdominal metastases is mandatory.
authors.affiliation: Department Medical Radiology, Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Marcelo A
authors.initials: MA
authors.lastname: Queiroz
authors.forename: Rahel A
authors.initials: RA
authors.lastname: Kubik-Huch
authors.forename: Nik
authors.initials: N
authors.lastname: Hauser
authors.forename: Bianka
authors.initials: B
authors.lastname: Freiwald-Chilla
authors.forename: Gustav
authors.initials: G
authors.lastname: von Schulthess
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Froehlich
authors.forename: Patrick
authors.initials: P
authors.lastname: Veit-Haibach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005833:Genital Neoplasms, Female / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18