Evaluation of the potential of PET-MRI fusion for detection of liver metastases in patients with neuroendocrine tumours.

Abstract

This study was performed to assess the role of retrospective PET-MRI fusion with Ga-68-DOTA(0)-Phe(1)-Tyr(3)-octreotide (Ga-68-DOTATOC) PET and Gd-EOB-DTPA MRI in the detection of hepatic metastases from neuroendocrine tumours (NET). Twenty-two consecutive patients with suspected liver metastases from histopathologically proven NET were examined with Gd-EOB-DTPA MRI and multiphase contrast-enhanced Ga-68-DOTATOC PET/CT. PET and MRI images were retrospectively fused using commercially available software. Two physicians experienced in nuclear medicine and radiology analysed the images to assess diagnostic confidence and characterise liver lesions. A total of 181 lesions were detected. PET-MRI showed a sensitivity of 91.2% (significantly superior to PET/CT; P < 0.05) and a specificity of 95.6% (significantly superior to MRI; P < 0.05). PET/CT had a sensitivity of 73.5% and a specificity of 88.2%. MRI had a sensitivity of 87.6% and a specificity of 86.8%. The area under the curve was 0.98 for PET-MRI, 0.96 for MRI, and 0.89 for PET/CT (P < 0.05). Retrospectively fused PET-MRI was superior to multiphase contrast-enhanced Ga-68-DOTATOC PET/CT and Gd-EOB-DTPA MRI in the detection of NET liver metastases. It was more sensitive than PET/CT and more specific than MRI. Fused PET-MRI therefore seems well suited for surgical and interventional treatment planning of NET liver metastases. • Ga-68-DOTATOC PET-Gd-EOB-DTPA MRI fusion can improve imaging of liver metastases of neuroendocrine tumours. • This technique appears more sensitive than PET/CT for staging NET hepatic metastases. • Ga-68-DOTATOC PET-Gd-EOB-DTPA MRI fusion is more specific than MRI alone.