Hybrid PET/MRI in non-small cell lung cancer (NSCLC) and lung nodules—a literature review

Sara E. Dahlsgaard-Wallenius*, Malene Grubbe Hildebrandt, Allan Johansen, Mie Holm Vilstrup, Henrik Petersen, Oke Gerke, Poul Flemming Høilund-Carlsen, Anni Morsing, Thomas Lund Andersen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: The use of hybrid PET/MRI for clinical staging is growing in several cancer forms and, consequently, PET/MRI has also gained interest in the assessment of non-small cell lung cancer (NSCLC) and lung lesions. However, lung evaluation with PET/MRI is associated with challenges related to technical issues and diagnostic image quality. We, therefore, investigated the published literature on PET/MRI for clinical staging in NSCLC or lung nodule detection specifically addressing diagnostic accuracy and technical issues. Methods: The data originates from a systematic search performed in PubMed/MEDLINE, Embase, and Cochrane Library on hybrid PET/MRI in patients with cancer for a scoping review published earlier (https://doi.org/10.1007/s00259-019-04402-8). Studies in English and German evaluating the diagnostic performance of hybrid PET/MRI for NSCLC or lung nodule detection in cancer patients were selected. Data reported in peer-reviewed journals without restrictions to year of publication were included. Results: A total of 3138 publications were identified from which 116 published 2012–2018 were included. Of these, nine studies addressed PET/MRI in NSCLC (4) or lung nodule detection (5). Overall, PET/MRI did not provide advantages in preoperative T- and N-staging in NSCLC compared to PET/CT. The data on M-staging were too few for conclusions to be drawn. The lung nodule detection rate of PET/MRI was comparable to that of PET/CT for FDG-avid nodules larger than 10 mm, but the sensitivity of PET/MRI for detection of non-FDG-avid nodules smaller than 5 mm was low. Conclusion: PET/MRI did not provide advantages in T- and N-staging of NSCLC compared to PET/CT. PET/MRI had a comparable sensitivity for detection of FDG-avid lung nodules and nodules over 10 mm, but PET/CT yielded a higher detection rate in non FDG-avid lung nodules under 5 mm. With PET/MRI, the overall detection rate for lung nodules in various cancer types remains inferior to that of PET/CT due to the lower diagnostic performance of MRI than CT in the lungs.

Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume48
Issue number2
Pages (from-to)584-591
Number of pages8
ISSN1619-7070
DOIs
Publication statusPublished - Feb 2021

Keywords

  • 18F-FDG
  • Lung lesions
  • NSCLC
  • PET/CT
  • PET/MRI

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