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


Authors: Mayerhoefer, M. E.; Prosch, H.; Beer, L.; Tamandl, D.; Beyer, T.; Hoeller, C.; Berzaczy, D.; Raderer, M.; Preusser, M.; Hochmair, M.; Kiesewetter, B.; Scheuba, C.; Ba-Ssalamah, A.; Karanikas, G.; Kesselbacher, J.; Prager, G.; Dieckmann, K.; Polterauer, S.; Weber, M.; Rausch, I.; Brauner, B.; Eidherr, H.; Wadsak, W.; Haug, A. R.
Article Title: PET/MRI versus PET/CT in oncology: A prospective single-center study of 330 examinations focusing on implications for patient management and cost considerations
Abstract: 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 [18F]FDG, [68Ga]Ga-DOTANOC, or [18F]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. © 2019, The Author(s).
Keywords: adult; controlled study; aged; unclassified drug; major clinical study; nuclear magnetic resonance imaging; positron emission tomography; follow up; diagnostic accuracy; prospective study; oncology; health care cost; patient care; fluorodeoxyglucose f 18; tracer; costs; pet/ct; 6 fluorodopa f 18; patient management; pet/mri; human; male; female; article; positron emission tomography-computed tomography; dotanoc ga 68
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 47
Issue: 1
ISSN: 1619-7070
Publisher: Springer  
Date Published: 2020-01-01
Start Page: 51
End Page: 60
Language: English
DOI: 10.1007/s00259-019-04452-y
PUBMED: 31410538
PROVIDER: scopus
PMCID: PMC6885019
DOI/URL:
Notes: Article -- Source: Scopus
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