title: Simultaneous [18F]FDG-PET/MRI: Correlation of Apparent Diffusion Coefficient (ADC) and Standardized Uptake Value (SUV) in Primary and Recurrent Cervical Cancer.
abstract: OBJECTIVE
  Previous non-simultaneous PET/MR studies have shown heterogeneous results about the correlation between standardized uptake values (SUVs) and apparent diffusion coefficients (ADCs). The aim of this study was to investigate correlations in patients with primary and recurrent tumors using a simultaneous PET/MRI system which could lead to a better understanding of tumor biology and might play a role in early response assessment.
  
  
  METHODS
  We included 31 patients with histologically confirmed primary (n = 14) or recurrent cervical cancer (n = 17) who underwent simultaneous whole-body 18F-FDG-PET/MRI comprising DWI. Image analysis was performed by a radiologist and a nuclear physician who identified tumor margins and quantified ADC and SUV. Pearson correlations were calculated to investigate the association between ADC and SUV.
  
  
  RESULTS
  92 lesions were detected. We found a significant inverse correlation between SUVmax and ADCmin (r = -0.532, p = 0.05) in primary tumors as well as in primary metastases (r = -0.362, p = 0.05) and between SUVmean and ADCmin (r = -0.403, p = 0.03). In recurrent local tumors we found correlations for SUVmax and ADCmin (r = -0.747, p = 0.002) and SUVmean and ADCmin (r = -0.773, p = 0.001). Associations for recurrent metastases were not significant (p>0.05).
  
  
  CONCLUSIONS
  Our study demonstrates the feasibility of fast and reliable measurement of SUV and ADC with simultaneous PET/MRI. In patients with cervical cancer we found significant inverse correlations for SUV and ADC which could play a major role for further tumor characterization and therapy decisions.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Brandmaier
authors.affiliation: Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Purz
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Bremicker
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Leipzig, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Höckel
authors.affiliation: Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Barthel
authors.affiliation: Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Kluge
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kahn
authors.affiliation: Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Sabri
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Stumpp
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18