title: Thoracic staging with18F-FDG PET/MR in non-small cell lung cancer - does it change therapeutic decisions in comparison to18F-FDG PET/CT?
abstract: OBJECTIVE
  To investigate whether differences in thoracic tumour staging between18F-FDG PET/CT and PET/MR imaging lead to different therapeutic decisions in Non-Small Cell Lung Cancer (NSCLC).
  
  
  METHODS
  Seventy-seven NSCLC patients that underwent whole-body18F-FDG PET/CT from the base of skull to the upper thighs and thoracic PET/MR were enrolled in this retrospective study. Thoracic PET/CT and PET/MR images were staged according to the 7th edition of the AJCC staging manual. Staging results of both modalities were discussed separately in a simulated interdisciplinary tumour board and therapeutic decisions based on both imaging modalities were recorded. Descriptive statistics were used to compare the results and reasons for changes in the therapeutic decision were investigated.
  
  
  RESULTS
  Staging results differed in 35 % of patients (27 patients) between thoracic PET/CT and PET/MR. Differences were detected when assessing the T-stage in 18 % (n = 14), the N-stage in 23 % (n = 18), and the M-stage in 1 % (n = 1). However, patient therapy management was changed in only six patients (8 %).
  
  
  CONCLUSIONS
  Despite the variability of thoracic18F-FDG PET/CT and PET/MR in TNM-staging, both modalities lead to comparable therapeutic decisions in patients suffering from NSCLC. Hence,18F-FDG PET/MR can be considered an possible alternative to18F-FDG PET/CT for clinical NSCLC staging.
  
  
  CONCLUSIONS
  • PET/CT and PET/MR provide comparable results in early stages in NSCLC • Clinical impact of different staging results has not been investigated • PET/CT and PET/MR lead to comparable therapeutic decisions • PET/MR can be considered an alternative to PET/CT for NSCLC staging.
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. Benedikt.Schaarschmidt@med.uni-duesseldorf.de.|Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, D-45147, Essen, Germany. Benedikt.Schaarschmidt@med.uni-duesseldorf.de.
authors.forename: Benedikt M
authors.initials: BM
authors.lastname: Schaarschmidt
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, D-45147, Essen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Grueneisen
authors.affiliation: Medical Faculty, Department of Medical Oncology, University Duisburg-Essen, Essen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Metzenmacher
authors.affiliation: Medical Faculty, Department of Nuclear Medicine, University Duisburg-Essen, D-45147, Essen, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Gomez
authors.affiliation: Medical Faculty, Radiation and Tumour Clinic, University Duisburg-Essen, D-45147, Essen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gauler
authors.affiliation: Ruhrlandklinik, Thoracic Surgery and Endoscopy, University Duisburg-Essen, Essen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Roesel
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Heusch
authors.affiliation: Medical Faculty, Department of Nuclear Medicine, University Duisburg-Essen, D-45147, Essen, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Ruhlmann
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, D-45147, Essen, Germany.
authors.forename: Lale
authors.initials: L
authors.lastname: Umutlu
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Buchbender
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Lung cancer; NSCLC; PET/CT; PET/MR; PET/MRI