For most cancers recurrence, lesion-level metastasis and patient-level regional nodal metastases, positron emission tomography/magnetic resonance imaging (PET/MRI) presents comparable pooled sensitivity to PET/computed tomography (PET/CT), in response to findings from a brand new systematic evaluation. Nevertheless, the authors of the evaluation additionally discovered that PET/MRI supplied important benefits in imaging for breast most cancers, colorectal most cancers, cervical most cancers, and liver most cancers.
For the systematic evaluation, lately revealed within the American Journal of Roentgenology, researchers reviewed findings from 29 comparative research (with a complete of 1,656 sufferers) involving the usage of fluorodeoxyglucose (FDG) PET/MRI and FDG PET/CT for diagnosing most cancers.
The researchers discovered pretty comparable total pooled sensitivity and specificity for the imaging modalities for most cancers recurrence and metastasis. In 5 research assessing the detection of lesion-level recurrence and/or metastases, the evaluation authors famous a 94 % sensitivity fee and 83 % specificity fee for PET/MRI compared to 91 % and 81 %, respectively for PET/CT.
In 5 different research analyzing patient-level regional nodal metastases, PET/MRI had comparable sensitivity to PET/CT (88 % vs. 86 %) and barely greater specificity (92 % vs. 86 %), in response to the evaluation authors.
The systematic evaluation authors identified that PET/MRI had staging accuracy charges that had been 23.5 % greater for breast most cancers (98 % vs. 74.5 %) and 27 % greater for colorectal most cancers (96.2 % vs. 69.2 %) than PET/CT.
Nevertheless, in different reviewed research, PET/MRI supplied sensitivity and staging accuracy charges that had been considerably greater than PET/CT throughout totally different sorts of most cancers.
Particularly, the evaluation authors identified that PET/MRI had staging accuracy charges that had been 23.5 % greater for breast most cancers (98 % vs. 74.5 %) and 27 % greater for colorectal most cancers (96.2 % vs. 69.2 %) than PET/CT. The researchers additionally famous a 27 % greater sensitivity with PET/MRI in detecting major cervical most cancers (93.2 % vs. 66.2 %).
“PET/MRI usually demonstrated comparable or higher efficiency with respect to PET/CT. For instance, PET/MRI confirmed higher efficiency than PET/CT in a pooled evaluation for detection of regional lymph node metastases and confirmed higher efficiency than PET/CT in particular person research regarding breast most cancers and colorectal most cancers staging, major detection of breast most cancers and cervical most cancers, detection of liver metastases, and detection of endometrial most cancers native invasion,” wrote lead meta-analysis creator Amit Singnurkar, MDCM, MPH, MBA, FRCPC, who’s affiliated with the Division of Medical Imaging on the College of Toronto in Canada, and colleagues.
Whereas the systematic evaluation didn’t specify the rationale behind PET/MRI’s stronger diagnostic efficiency in particular person research, the authors steered key capabilities and rising advances with MRI.
“ … The enhancements probably associated to the excessive delicate tissue distinction and delicate tissue differentiation of MRI, in addition to the usage of superior sequences resembling (diffusion-weighted imaging) DWI,” posited Singnurkar and colleagues. “The benefits of PET/MRI can help lesion detection and characterization in anatomic areas together with the liver and pelvis.”
Three Key Takeaways
1. Comparable pooled sensitivity and specificity charges. PET/MRI presents comparable pooled sensitivity and specificity to PET/CT for detecting most cancers recurrence and metastasis. Particularly, PET/MRI confirmed a sensitivity fee of 94 % and specificity fee of 83 %, in comparison with PET/CT’s 91 % sensitivity and 81 % specificity.
2. Larger accuracy in particular person research taking a look at particular cancers. PET/MRI demonstrated considerably greater staging accuracy charges for breast most cancers (98 % vs. 74.5 %) and colorectal most cancers (96.2 % vs. 69.2 %) in comparison with PET/CT. Moreover, PET/MRI had the next sensitivity in detecting major cervical most cancers (93.2 % vs. 66.2 %).
3. Challenges with PET/MRI: Regardless of its diagnostic benefits, PET/MRI faces challenges resembling restricted availability, greater value, operational complexity, and longer examination instances. These components have an effect on affected person tolerability and throughput. The evaluation authors identified that roughly 30 PET/MRI methods can be found in the USA in comparison with over 1,600 PET/CT methods.
For the analysis of lesion-level liver metastasis, the researchers famous PET/MRI sensitivity ranging between 91.1 to 98 % in distinction to 42.3-71.1 % for PET/CT.
Nevertheless, the evaluation authors famous numerous challenges with PET/MRI with entry being notably restricted.
“PET/MRI methods are much less broadly accessible than PET/CT methods as a result of greater value and operational complexity, with roughly 30 PET/MRI methods versus over 1,600 PET/CT methods put in in the USA. Moreover, PET/MRI has considerably longer examination instances, impacting affected person tolerability and throughput,” defined Singnurkar and colleagues.
(Editor’s word: For associated content material, see “Research: PSMA PET/CT Extra Advantageous than MRI for Locoregional Staging of Prostate Most cancers,” “PET/CT or mPMRI: Which is Higher for Detecting Biomechanical Recurrence of Prostate Most cancers?” and “SNMMI: New Research Suggests Deserves of FAPI PET/CT for Breast Most cancers Staging.”)
In regard to limitation of the meta-analysis, the authors conceded a scarcity of readability on bias threat in 26 of the reviewed research and steered publication bias with a potential emphasis on reporting research on PET/MRI with favorable outcomes. The researchers additionally famous variability with picture acquisition protocols and that the FDG PET focus of the meta-analysis precluded any dialogue of newer PET radiotracers.
