title: Speeding up PET/MR for cancer staging of children and young adults.
abstract: OBJECTIVE
  Combining18F-FDG PET with whole-body MR for paediatric cancer staging is practically feasible if imaging protocols can be streamlined. We compared18F-FDG PET/STIR with accelerated18F-FDG PET/FSPGR for whole-body tumour imaging in children and young adults.
  
  
  METHODS
  Thirty-three children and young adults (17.5 ± 5.5 years, range 10-30) with malignant lymphoma or sarcoma underwent a18F-FDG PET staging examination, followed by ferumoxytol-enhanced STIR and FSPGR whole-body MR.18F-FDG PET scans were fused with MR data and the number and location of tumours on each integrated examination were determined. Histopathology and follow-up imaging served as standard of reference. The agreement of each MR sequence with the reference and whole-body imaging times were compared using Cohen's kappa coefficient and Student's t-test, respectively.
  
  
  RESULTS
  Comparing18F-FDG PET/FSPGR to18F-FDG PET/STIR, sensitivities were 99.3 % for both, specificities were statistically equivalent, 99.8 versus 99.9 %, and the agreement with the reference based on Cohen's kappa coefficient was also statistically equivalent, 0.989 versus 0.992. However, the total scan-time for accelerated FSPGR of 19.8 ± 5.3 minutes was significantly shorter compared to 29.0 ± 7.6 minutes for STIR (p = 0.001).
  
  
  CONCLUSIONS
  F-FDG PET/FSPGR demonstrated equivalent sensitivities and specificities for cancer staging compared to18F-FDG PET/STIR, but could be acquired with shorter acquisition time.
  
  
  CONCLUSIONS
  • Breath-hold FSPGR sequences shorten the data acquisition time for whole-body MR and PET/MR. • Ferumoxytol provides long-lasting vascular contrast for whole-body MR and PET/MR. •18F-FDG PET/FSPGR data provided equal sensitivity and specificity for cancer staging compared to18F-FDG PET/STIR.
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Maryam
authors.initials: M
authors.lastname: Aghighi
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Laura Jean
authors.initials: LJ
authors.lastname: Pisani
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Ziyan
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Klenk
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Himani
authors.initials: H
authors.lastname: Madnawat
authors.affiliation: Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA.
authors.forename: Sandra Luna
authors.initials: SL
authors.lastname: Fineman
authors.affiliation: Department of Medicine, Stanford Hospital, Stanford University, Stanford, CA, USA.
authors.forename: Ranjana
authors.initials: R
authors.lastname: Advani
authors.affiliation: Department of Radiation and Oncology, Stanford University, Stanford, CA, USA.
authors.forename: Rie
authors.initials: R
authors.lastname: Von Eyben
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Owen
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Quon
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Moseley
authors.affiliation: Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA. heiked@stanford.edu.
authors.forename: Heike E
authors.initials: HE
authors.lastname: Daldrup-Link
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012509:Sarcoma / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013997:Time Factors; D051598:Whole Body Imaging / Q000379:methods*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Iron oxide nanoparticles; PET/CT; Paediatric cancer; STIR; Whole-body PET/MR imaging