Details

Autor(en) / Beteiligte

• Mayerhoefer, Marius E.
• Prosch, Helmut
• Beer, Lucian
• Tamandl, Dietmar
• Beyer, Thomas
• Hoeller, Christoph
• Berzaczy, Dominik
• Raderer, Markus
• Preusser, Matthias
• Hochmair, Maximilian
• Kiesewetter, Barbara
• Scheuba, Christian
• Ba-Ssalamah, Ahmed
• Karanikas, Georgios
• Kesselbacher, Julia
• Prager, Gerald
• Dieckmann, Karin
• Polterauer, Stephan
• Weber, Michael
• Rausch, Ivo
• Brauner, Bernhard
• Eidherr, Harald
• Wadsak, Wolfgang
• Haug, Alexander R.

Titel

PET/MRI versus PET/CT in oncology: a prospective single-center study of 330 examinations focusing on implications for patient management and cost considerations

Ist Teil von

• European journal of nuclear medicine and molecular imaging, 2020-01, Vol.47 (1), p.51-60

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Purpose PET/MRI has recently been introduced into clinical practice. We prospectively investigated the clinical impact of PET/MRI compared with PET/CT, in a mixed population of cancer patients, and performed an economic evaluation of PET/MRI. Methods Cancer patients referred for routine staging or follow-up by PET/CT underwent consecutive PET/CT and PET/MRI, using single applications of [ 18 F]FDG, [ 68 Ga]Ga-DOTANOC, or [ 18 F]FDOPA, depending on tumor histology. PET/MRI and PET/CT were rated separately, and lesions were assessed per anatomic region; based on regions, per-examination and per-patient accuracies were determined. A simulated, multidisciplinary team meeting served as reference standard and determined whether differences between PET/CT and PET/MRI affected patient management. The McNemar tests were used to compare accuracies, and incremental cost-effectiveness ratios (ICERs) for PET/MRI were calculated. Results Two hundred sixty-three patients (330 same-day PET/CT and PET/MRI examinations) were included. PET/MRI was accurate in 319/330 examinations and PET/CT in 277/330 examinations; the respective accuracies of 97.3% and 83.9% differed significantly ( P  < 0.001). The additional findings on PET/MRI—mainly liver and brain metastases—had implications for patient management in 21/263 patients (8.0%). The per-examination cost was 596.97 EUR for PET/MRI and 405.95 EUR for PET/CT. ICERs for PET/MRI were 14.26 EUR per percent of diagnostic accuracy and 23.88 EUR per percent of correctly managed patients. Conclusions PET/MRI enables more appropriate management than PET/CT in a nonnegligible fraction of cancer patients. Since the per-examination cost is about 50% higher for PET/MRI than for PET/CT, a histology-based triage of patients to either PET/MRI or PET/CT may be meaningful.