ArticleWorld journal of nuclear medicine2025
Incremental Value of Digital PET/MRI over PET/CT in the Assessment of Neoplastic Liver Lesions.
Article in World journal of nuclear medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: The objective of this study was to assess the performance of positron emission tomography/magnetic resonance imaging (PET/MRI) compared with PET/computed tomography (PET/CT) in the clinical management of patients with neoplastic hepatic lesions. Materials and Methods: This is a retrospective study and includes a sample size of 15 patients, referred for diagnostic evaluation and staging of neoplastic hepatic lesions. The patients included in this study underwent a simultaneous PET/CT scan on uMI-Vista and a complementary liver PET/MRI scan on uPMR 790. PET/CT and PET/MRI were compared based on the number of detected lesions, the smallest detected lesion diameter, and tumor-to-liver ratio (TLR). The histopathological analysis was considered the standard of reference. Results: PET/MRI reported extra information in 87% (13/15) of patients, and additional lesions were identified in 73% (11/15) of patients. Furthermore, PET/MRI could identify subcentimeter liver lesions and added great value in the evaluation of lesion viability. Overall, 40 additional lesions were detected with PET/MRI in contrast with PET/CT within the given patient cohort. The smallest revealed lesion measured 2 mm in the long-axis diameter, and the average long-axis diameter of small lesions detected by PET/MRI across 15 patients was 3.4 mm with a standard deviation of 1.3 mm. These findings significantly affected the final outcomes in 12 out of 15 patients, leading to modifications in the response assessment category in 5 patients and defined the malignant hepatic lesions on staging/restaging scans (10/15). Discussion: PET/MRI has been found to outperform PET/CT in terms of conspicuity of liver lesions, with better sensitivity and specificity. Overall, coregistered PET and MR images have been shown to outperform PET/CT in the imaging of liver lesions, with better delineation of small lesions as well as reliable localization of lesions to the corresponding liver segment. Conclusion: In addition to a significant decrease in radiation exposure, the PET/MRI combination resulted in higher detection rates and more precise characterization of small malignant liver lesions and tends to be more powerful than PET/CT, which has a direct impact on the patient's diagnosis, staging, and further therapeutic strategies.
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