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PLoS One. 2017 Jan 19;12(1):e0167262. doi: 10.1371/journal.pone.0167262. eCollection 2017.

Conspicuity of Malignant Lesions on PET/CT and Simultaneous Time-Of-Flight PET/MRI.

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Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, California, United States of America.
Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California, United States of America.
Department of Radiology, Stanford University, Stanford, California, United States of America.



To compare the conspicuity of malignant lesions between FDG PET/CT and a new simultaneous, time-of-flight (TOF) enabled PET/MRI scanner.


All patients underwent a single-injection of FDG, followed by a dual imaging protocol consisting of PET/CT followed by TOF PET/MRI. PET/CT and PET/MRI images were evaluated by two readers independently for areas of FDG uptake compatible with malignancy, and then categorized into 5 groups (1: PET/MRI and PET/CT positive; 2: PET/MRI positive, PET/CT positive in retrospect; 3: PET/CT positive, PET/MRI positive in retrospect; 4: PET/MRI positive, PET/CT negative; 5: PET/MRI negative, PET/CT positive) by consensus. Patients with no lesions on either study or greater than 10 lesions based on either modality were excluded from the study.


Fifty-two patients (mean±SD age: 58±14 years) underwent the dual imaging protocol; of these, 29 patients with a total of 93 FDG-avid lesions met the inclusion criteria. The majority of lesions (56%) were recorded prospectively in the same location on PET/CT and PET/MRI. About an equal small fraction of lesions were seen on PET/CT but only retrospectively on PET/MRI (9%) and vice versa (12%). More lesions were identified only on PET/MRI but not on PET/CT, even in retrospect (96% vs. 81%, respectively; p = 0.003). Discrepant lesions had lower maximum standardized uptake value (SUVmax) than concordant lesions on both modalities (p<0.001).


While most lesions were identified prospectively on both modalities, significantly more lesions were identified with PET/MRI than with PET/CT.

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