Abstract

Background

18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) may improve cancer staging by combining sensitive cancer detection with high-contrast resolution and detail. We compared the diagnostic performance of 18F-FDG PET/MRI to 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging oesophageal/gastro-oesophageal cancer. Following ethical approval and informed consent, participants with newly diagnosed primary oesophageal/gastro-oesophageal cancer were enrolled. Exclusions included prior/concurrent malignancy. Following 324 ± 28 MBq 18F-FDG administration and 60-min uptake, PET/CT was performed, immediately followed by integrated PET/MRI from skull base to mid-thigh. PET/CT was interpreted by two dual-accredited nuclear medicine physicians and PET/MRI by a dual-accredited nuclear medicine physician/radiologist and cancer radiologist in consensus. Per-participant staging was compared with the tumour board consensus staging using the McNemar test, with statistical significance at 5%.

Results

Out of 26 participants, 22 (20 males; mean ± SD age 68.8 ± 8.7 years) completed 18F-FDG PET/CT and PET/MRI. Compared to the tumour board, the primary tumour was staged concordantly in 55% (12/22) with PET/MRI and 36% (8/22) with PET/CT; the nodal stage was concordant in 45% (10/22) with PET/MRI and 50% (11/22) with PET/CT. There was no statistical difference in PET/CT and PET/MRI staging performance (p > 0.05, for T and N staging). The staging of distant metastases was concordant with the tumour board in 95% (21/22) with both PET/MRI and PET/CT. Of participants with distant metastatic disease, PET/MRI detected additional metastases in 30% (3/10).

Conclusion

In this preliminary study, compared to 18F-FDG PET/CT, 18F-FDG PET/MRI showed non-significant higher concordance with T-staging, but no difference with N or M-staging. Additional metastases detected by 18F-FDG PET/MRI may be of additive clinical value.

Details

Title
Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI
Author
Sharkey, Amy R. 1   VIAFID ORCID Logo  ; Sah, Bert-Ram 2 ; Withey, Samuel J. 1 ; Bhuva, Shaheel 3 ; Neji, Radhouene 4 ; Jeljeli, Sami 3 ; Green, Adrian 5 ; Cook, Gary J. R. 6 ; Goh, Vicky 1 ; Baker, C. R.; Chang, F.; Chicklore, S.; Cominos, M.; Coombes, A.; Davies, A. R.; George, S.; Gill-Barman, B.; Dunn, J. N.; Gossage, J. A.; Griffin, N.; Hill, M.; Hynes, O.; Iezzi, C.; Jacques, A.; Kelly, M.; Mahadeva, U.; Maisey, N.; McEwan, R.; Meenan, J.; Ngan, S.; Owczarczyk, K.; Qureshi, A.; Reyhani, A.; Subesinghe, M.; Tham, G.; Waters, J.; Zeki, S. S.

1  King’s College London, Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764); Guy’s and St Thomas’ NHS Foundation Trust, Department of Radiology, London, UK (GRID:grid.420545.2) 
2  University of Bern, Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157) 
3  St Thomas’ Hospital, King’s College London and Guy’s and St Thomas’ PET Centre, London, UK (GRID:grid.425213.3) 
4  Siemens Healthcare, MR Research Collaborations, Frimley, UK (GRID:grid.14601.32) 
5  King’s College London, Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764) 
6  King’s College London, Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764); St Thomas’ Hospital, King’s College London and Guy’s and St Thomas’ PET Centre, London, UK (GRID:grid.425213.3) 
Pages
23
Publication year
2021
Publication date
Dec 2021
Publisher
Springer Nature B.V.
e-ISSN
3005-074X
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s41824-021-00117-y
ProQuest document ID
2609166320
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.