TY - JOUR
T1 - Multiparametric FDG-PET/MRI of Hepatocellular Carcinoma
T2 - Initial Experience
AU - Hectors, Stefanie J.
AU - Wagner, Mathilde
AU - Besa, Cecilia
AU - Huang, Wei
AU - Taouli, Bachir
N1 - Publisher Copyright:
© 2018 Stefanie J. Hectors et al.
PY - 2018
Y1 - 2018
N2 - Purpose. To compare multiparametric (mp)FDG-PET/MRI metrics between hepatocellular carcinoma (HCC) and liver parenchyma and to assess the correlation between mpMRI and FDG-PET standard uptake values (SUVs) in liver parenchyma and HCC. Methods. This prospective, institutional review board-Approved study enrolled 15 patients (M/F 12/3; mean age 61 y) with HCC. mpMRI including blood-oxygen-level-dependent (BOLD) MRI, intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced-(DCE-) MRI was performed simultaneously with 18F-FDG-PET on a 3T PET/MRI hybrid system. Quantitative BOLD, IVIM and DCE-MRI parameters (Tofts model (TM) and shutter-speed model (SSM)), and PET parameters (SUVmean and SUVmax) were quantified and compared between HCC lesions and liver parenchyma using Wilcoxon signed-rank tests. SUV ratios between HCCs and liver were also calculated (SUVmean T/L and SUVmax T/L). Diagnostic performance of (combined) mp-PET/MRI parameters for characterization of HCC was assessed using ROC analysis. Spearman correlations between PET and mpMRI parameters in HCC tumors and liver parenchyma were evaluated. Results. 21 HCC lesions (mean size 4.0 ± 2.4 cm; range 2-13 cm) were analyzed. HCCs exhibited significantly higher arterial fraction (from DCE-MRI) and lower R2pre-O2 and post-O2 (from BOLD-MRI) versus liver parenchyma (P<0.032). The highest diagnostic performance for differentiation between HCC and liver parenchyma was achieved for combined ART SSM and R2 post-O2 (AUC = 0.91). SUVmax showed reasonable performance for differentiation of HCC versus liver (AUC = 0.75). In HCC, DCE-MRI parameters Ktrans (TM and SSM) and ve TM exhibited significant negative correlations with SUVmax T/L (r ranges from-0.624 to-0.566; FDR-Adjusted P<0.050). Conclusions. Despite the observed reasonable diagnostic performance of FDG-PET SUVmax for HCC detection and several significant correlations between FDG-PET SUV and DCE-MRI parameters, FDG-PET did not provide clear additional value for HCC characterization compared to mpMRI in this pilot study.
AB - Purpose. To compare multiparametric (mp)FDG-PET/MRI metrics between hepatocellular carcinoma (HCC) and liver parenchyma and to assess the correlation between mpMRI and FDG-PET standard uptake values (SUVs) in liver parenchyma and HCC. Methods. This prospective, institutional review board-Approved study enrolled 15 patients (M/F 12/3; mean age 61 y) with HCC. mpMRI including blood-oxygen-level-dependent (BOLD) MRI, intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced-(DCE-) MRI was performed simultaneously with 18F-FDG-PET on a 3T PET/MRI hybrid system. Quantitative BOLD, IVIM and DCE-MRI parameters (Tofts model (TM) and shutter-speed model (SSM)), and PET parameters (SUVmean and SUVmax) were quantified and compared between HCC lesions and liver parenchyma using Wilcoxon signed-rank tests. SUV ratios between HCCs and liver were also calculated (SUVmean T/L and SUVmax T/L). Diagnostic performance of (combined) mp-PET/MRI parameters for characterization of HCC was assessed using ROC analysis. Spearman correlations between PET and mpMRI parameters in HCC tumors and liver parenchyma were evaluated. Results. 21 HCC lesions (mean size 4.0 ± 2.4 cm; range 2-13 cm) were analyzed. HCCs exhibited significantly higher arterial fraction (from DCE-MRI) and lower R2pre-O2 and post-O2 (from BOLD-MRI) versus liver parenchyma (P<0.032). The highest diagnostic performance for differentiation between HCC and liver parenchyma was achieved for combined ART SSM and R2 post-O2 (AUC = 0.91). SUVmax showed reasonable performance for differentiation of HCC versus liver (AUC = 0.75). In HCC, DCE-MRI parameters Ktrans (TM and SSM) and ve TM exhibited significant negative correlations with SUVmax T/L (r ranges from-0.624 to-0.566; FDR-Adjusted P<0.050). Conclusions. Despite the observed reasonable diagnostic performance of FDG-PET SUVmax for HCC detection and several significant correlations between FDG-PET SUV and DCE-MRI parameters, FDG-PET did not provide clear additional value for HCC characterization compared to mpMRI in this pilot study.
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U2 - 10.1155/2018/5638283
DO - 10.1155/2018/5638283
M3 - Article
C2 - 30402045
AN - SCOPUS:85055347320
SN - 1555-4309
VL - 2018
JO - Contrast Media and Molecular Imaging
JF - Contrast Media and Molecular Imaging
M1 - 5638283
ER -