Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI

Amy R. Sharkey; Bert-ram Sah; Samuel J. Withey; Shaheel Bhuva; Radhouene Neji; Sami Jeljeli; Adrian Green; Gary J. R. Cook; Vicky Goh; C. R. Baker; F. Chang; S. Chicklore; M. Cominos; A. Coombes; A. R. Davies; S. George; B. Gill-barman; J. N. Dunn; J. A. Gossage; N. Griffin; M. Hill; O. Hynes; C. Iezzi; A. Jacques; M. Kelly; U. Mahadeva; N. Maisey; R. Mcewan; J. Meenan; S. Ngan; K. Owczarczyk; A. Qureshi; A. Reyhani; M. Subesinghe; G. Tham; J. Waters; S. S. Zeki

doi:10.1186/s41824-021-00117-y

Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI

Amy R. Sharkey, Bert-ram Sah, Samuel J. Withey, Shaheel Bhuva, Radhouene Neji, Sami Jeljeli, Adrian Green, Gary J. R. Cook, Vicky Goh, C. R. Baker, F. Chang, S. Chicklore, M. Cominos, A. Coombes, A. R. Davies, S. George, B. Gill-barman, J. N. Dunn, J. A. Gossage, N. GriffinM. Hill, O. Hynes, C. Iezzi, A. Jacques, M. Kelly, U. Mahadeva, N. Maisey, R. Mcewan, J. Meenan, S. Ngan, K. Owczarczyk, A. Qureshi, A. Reyhani, M. Subesinghe, G. Tham, J. Waters, S. S. Zeki

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Abstract

Background: ¹⁸F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) may improve cancer staging by combining sensitive cancer detection with high-contrast resolution and detail. We compared the diagnostic performance of 18F-FDG PET/MRI to ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging oesophageal/gastro-oesophageal cancer. Following ethical approval and informed consent, participants with newly diagnosed primary oesophageal/gastro-oesophageal cancer were enrolled. Exclusions included prior/concurrent malignancy. Following 324 ± 28 MBq 18F-FDG administration and 60-min uptake, PET/CT was performed, immediately followed by integrated PET/MRI from skull base to mid-thigh. PET/CT was interpreted by two dual-accredited nuclear medicine physicians and PET/MRI by a dual-accredited nuclear medicine physician/radiologist and cancer radiologist in consensus. Per-participant staging was compared with the tumour board consensus staging using the McNemar test, with statistical significance at 5%. Results: Out of 26 participants, 22 (20 males; mean ± SD age 68.8 ± 8.7 years) completed 18F-FDG PET/CT and PET/MRI. Compared to the tumour board, the primary tumour was staged concordantly in 55% (12/22) with PET/MRI and 36% (8/22) with PET/CT; the nodal stage was concordant in 45% (10/22) with PET/MRI and 50% (11/22) with PET/CT. There was no statistical difference in PET/CT and PET/MRI staging performance (p > 0.05, for T and N staging). The staging of distant metastases was concordant with the tumour board in 95% (21/22) with both PET/MRI and PET/CT. Of participants with distant metastatic disease, PET/MRI detected additional metastases in 30% (3/10). Conclusion: In this preliminary study, compared to 18F-FDG PET/CT, 18F-FDG PET/MRI showed non-significant higher concordance with T-staging, but no difference with N or M-staging. Additional metastases detected by 18F-FDG PET/MRI may be of additive clinical value.

Original language	English
Article number	23
Journal	European Journal of Hybrid Imaging
Volume	5
Issue number	1
Early online date	13 Dec 2021
DOIs	https://doi.org/10.1186/s41824-021-00117-y
Publication status	Published - Dec 2021

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Sharkey, A. R., Sah, B., Withey, S. J., Bhuva, S., Neji, R., Jeljeli, S., Green, A., Cook, G. J. R., Goh, V., Baker, C. R., Chang, F., Chicklore, S., Cominos, M., Coombes, A., Davies, A. R., George, S., Gill-barman, B., Dunn, J. N., Gossage, J. A., ... Zeki, S. S. (2021). Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI. European Journal of Hybrid Imaging, 5(1), Article 23. https://doi.org/10.1186/s41824-021-00117-y

@article{bc91f4a952374402a433f7c10cd5fab4,

title = "Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI",

abstract = "Background: 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) may improve cancer staging by combining sensitive cancer detection with high-contrast resolution and detail. We compared the diagnostic performance of 18F-FDG PET/MRI to 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging oesophageal/gastro-oesophageal cancer. Following ethical approval and informed consent, participants with newly diagnosed primary oesophageal/gastro-oesophageal cancer were enrolled. Exclusions included prior/concurrent malignancy. Following 324 ± 28 MBq 18F-FDG administration and 60-min uptake, PET/CT was performed, immediately followed by integrated PET/MRI from skull base to mid-thigh. PET/CT was interpreted by two dual-accredited nuclear medicine physicians and PET/MRI by a dual-accredited nuclear medicine physician/radiologist and cancer radiologist in consensus. Per-participant staging was compared with the tumour board consensus staging using the McNemar test, with statistical significance at 5%. Results: Out of 26 participants, 22 (20 males; mean ± SD age 68.8 ± 8.7 years) completed 18F-FDG PET/CT and PET/MRI. Compared to the tumour board, the primary tumour was staged concordantly in 55% (12/22) with PET/MRI and 36% (8/22) with PET/CT; the nodal stage was concordant in 45% (10/22) with PET/MRI and 50% (11/22) with PET/CT. There was no statistical difference in PET/CT and PET/MRI staging performance (p > 0.05, for T and N staging). The staging of distant metastases was concordant with the tumour board in 95% (21/22) with both PET/MRI and PET/CT. Of participants with distant metastatic disease, PET/MRI detected additional metastases in 30% (3/10). Conclusion: In this preliminary study, compared to 18F-FDG PET/CT, 18F-FDG PET/MRI showed non-significant higher concordance with T-staging, but no difference with N or M-staging. Additional metastases detected by 18F-FDG PET/MRI may be of additive clinical value. ",

author = "Sharkey, {Amy R.} and Bert-ram Sah and Withey, {Samuel J.} and Shaheel Bhuva and Radhouene Neji and Sami Jeljeli and Adrian Green and Cook, {Gary J. R.} and Vicky Goh and Baker, {C. R.} and F. Chang and S. Chicklore and M. Cominos and A. Coombes and Davies, {A. R.} and S. George and B. Gill-barman and Dunn, {J. N.} and Gossage, {J. A.} and N. Griffin and M. Hill and O. Hynes and C. Iezzi and A. Jacques and M. Kelly and U. Mahadeva and N. Maisey and R. Mcewan and J. Meenan and S. Ngan and K. Owczarczyk and A. Qureshi and A. Reyhani and M. Subesinghe and G. Tham and J. Waters and Zeki, {S. S.}",

note = "Funding Information: The authors acknowledge financial support from the Department of Health via the NIHR Comprehensive Biomedical Research Centre award to the Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London/King's College Hospital NHS Foundation Trust, Wellcome EPSRC Centre for Medical Engineering at King{\textquoteright}s College London (WT 203148/Z/16/Z) and Cancer Research UK National Cancer Imaging Translational Accelerator Award (C4278/A27066). Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1186/s41824-021-00117-y",

language = "English",

volume = "5",

journal = "European Journal of Hybrid Imaging",

issn = "2510-3636",

publisher = "SpringerOpen",

number = "1",

}

Sharkey, AR, Sah, B, Withey, SJ, Bhuva, S , Neji, R, Jeljeli, S, Green, A, Cook, GJR , Goh, V , Baker, CR , Chang, F , Chicklore, S, Cominos, M, Coombes, A, Davies, AR , George, S , Gill-barman, B , Dunn, JN , Gossage, JA , Griffin, N , Hill, M, Hynes, O, Iezzi, C, Jacques, A, Kelly, M , Mahadeva, U , Maisey, N, Mcewan, R, Meenan, J, Ngan, S , Owczarczyk, K , Qureshi, A, Reyhani, A, Subesinghe, M, Tham, G, Waters, J & Zeki, SS 2021, 'Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI', European Journal of Hybrid Imaging, vol. 5, no. 1, 23. https://doi.org/10.1186/s41824-021-00117-y

TY - JOUR

T1 - Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI

AU - Sharkey, Amy R.

AU - Sah, Bert-ram

AU - Withey, Samuel J.

AU - Bhuva, Shaheel

AU - Neji, Radhouene

AU - Jeljeli, Sami

AU - Green, Adrian

AU - Cook, Gary J. R.

AU - Goh, Vicky

AU - Baker, C. R.

AU - Chang, F.

AU - Chicklore, S.

AU - Cominos, M.

AU - Coombes, A.

AU - Davies, A. R.

AU - George, S.

AU - Gill-barman, B.

AU - Dunn, J. N.

AU - Gossage, J. A.

AU - Griffin, N.

AU - Hill, M.

AU - Hynes, O.

AU - Iezzi, C.

AU - Jacques, A.

AU - Kelly, M.

AU - Mahadeva, U.

AU - Maisey, N.

AU - Mcewan, R.

AU - Meenan, J.

AU - Ngan, S.

AU - Owczarczyk, K.

AU - Qureshi, A.

AU - Reyhani, A.

AU - Subesinghe, M.

AU - Tham, G.

AU - Waters, J.

AU - Zeki, S. S.

N1 - Funding Information: The authors acknowledge financial support from the Department of Health via the NIHR Comprehensive Biomedical Research Centre award to the Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London/King's College Hospital NHS Foundation Trust, Wellcome EPSRC Centre for Medical Engineering at King’s College London (WT 203148/Z/16/Z) and Cancer Research UK National Cancer Imaging Translational Accelerator Award (C4278/A27066). Publisher Copyright: © 2021, The Author(s).

PY - 2021/12

Y1 - 2021/12

N2 - Background: 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) may improve cancer staging by combining sensitive cancer detection with high-contrast resolution and detail. We compared the diagnostic performance of 18F-FDG PET/MRI to 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging oesophageal/gastro-oesophageal cancer. Following ethical approval and informed consent, participants with newly diagnosed primary oesophageal/gastro-oesophageal cancer were enrolled. Exclusions included prior/concurrent malignancy. Following 324 ± 28 MBq 18F-FDG administration and 60-min uptake, PET/CT was performed, immediately followed by integrated PET/MRI from skull base to mid-thigh. PET/CT was interpreted by two dual-accredited nuclear medicine physicians and PET/MRI by a dual-accredited nuclear medicine physician/radiologist and cancer radiologist in consensus. Per-participant staging was compared with the tumour board consensus staging using the McNemar test, with statistical significance at 5%. Results: Out of 26 participants, 22 (20 males; mean ± SD age 68.8 ± 8.7 years) completed 18F-FDG PET/CT and PET/MRI. Compared to the tumour board, the primary tumour was staged concordantly in 55% (12/22) with PET/MRI and 36% (8/22) with PET/CT; the nodal stage was concordant in 45% (10/22) with PET/MRI and 50% (11/22) with PET/CT. There was no statistical difference in PET/CT and PET/MRI staging performance (p > 0.05, for T and N staging). The staging of distant metastases was concordant with the tumour board in 95% (21/22) with both PET/MRI and PET/CT. Of participants with distant metastatic disease, PET/MRI detected additional metastases in 30% (3/10). Conclusion: In this preliminary study, compared to 18F-FDG PET/CT, 18F-FDG PET/MRI showed non-significant higher concordance with T-staging, but no difference with N or M-staging. Additional metastases detected by 18F-FDG PET/MRI may be of additive clinical value.

AB - Background: 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) may improve cancer staging by combining sensitive cancer detection with high-contrast resolution and detail. We compared the diagnostic performance of 18F-FDG PET/MRI to 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging oesophageal/gastro-oesophageal cancer. Following ethical approval and informed consent, participants with newly diagnosed primary oesophageal/gastro-oesophageal cancer were enrolled. Exclusions included prior/concurrent malignancy. Following 324 ± 28 MBq 18F-FDG administration and 60-min uptake, PET/CT was performed, immediately followed by integrated PET/MRI from skull base to mid-thigh. PET/CT was interpreted by two dual-accredited nuclear medicine physicians and PET/MRI by a dual-accredited nuclear medicine physician/radiologist and cancer radiologist in consensus. Per-participant staging was compared with the tumour board consensus staging using the McNemar test, with statistical significance at 5%. Results: Out of 26 participants, 22 (20 males; mean ± SD age 68.8 ± 8.7 years) completed 18F-FDG PET/CT and PET/MRI. Compared to the tumour board, the primary tumour was staged concordantly in 55% (12/22) with PET/MRI and 36% (8/22) with PET/CT; the nodal stage was concordant in 45% (10/22) with PET/MRI and 50% (11/22) with PET/CT. There was no statistical difference in PET/CT and PET/MRI staging performance (p > 0.05, for T and N staging). The staging of distant metastases was concordant with the tumour board in 95% (21/22) with both PET/MRI and PET/CT. Of participants with distant metastatic disease, PET/MRI detected additional metastases in 30% (3/10). Conclusion: In this preliminary study, compared to 18F-FDG PET/CT, 18F-FDG PET/MRI showed non-significant higher concordance with T-staging, but no difference with N or M-staging. Additional metastases detected by 18F-FDG PET/MRI may be of additive clinical value.

UR - http://www.scopus.com/inward/record.url?scp=85121330610&partnerID=8YFLogxK

U2 - 10.1186/s41824-021-00117-y

DO - 10.1186/s41824-021-00117-y

M3 - Article

SN - 2510-3636

VL - 5

JO - European Journal of Hybrid Imaging

JF - European Journal of Hybrid Imaging

IS - 1

M1 - 23

ER -

Initial experience in staging primary oesophageal/gastro-oesophageal cancer with 18F-FDG PET/MRI

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