Background Somatostatin receptor (SSTR) positron emission tomography (PET) is a cornerstone of neuroendocrine tumor (NET) management. Hybrid PET/magnetic resonance imaging (MRI) is now available for NET-imaging, next to PET/computed tomography (CT). Objectives To determine whether CT or MRI is the best hybrid partner for [68Ga]Ga-DOTATATE PET. Design Monocentric, prospective study. Methods Patients received a same-day [68Ga]Ga-DOTATATE PET/CT and subsequent PET/MRI, for suspicion of NET, (re)staging or peptide receptor radionuclide therapy-selection. The union (PETunion) of malignant lesions detected on PETCT and PETMRI was the reference standard. Concordance of detection of malignant lesions in an organ was measured between PETunion and CT and PETunion and MRI. Seven bins were used to categorize the number of malignant lesions, containing following ordinal variables: 0, 1, 2-5, 6-10, 11-20, >20 countable and diffuse/uncountable. The difference in number of malignant lesions was obtained as the difference in bin level ('Δbin') between PETunion and CT and PETunion and MRI with a Δbin closer to zero implying a higher concordance rate. Results Twenty-nine patients were included. Primary tumors included 17 gastroenteropancreatic-NETs, 1 colon neuroendocrine carcinoma, 7 lung-NETs and 2 meningiomas. Patient level concordance with PETunion was 96% for MRI and 67% for CT (p = 0.039). Organ level concordance with PETunion was 74% for MRI and 40% for CT (p < 0.0001). In bone, there was a higher concordance rate for MRI compared to CT, 92% and 33%, respectively (p = 0.016). Overall, a mean Δbin of 0.5 ± 1.1 for PETunion/MRI and 1.4 ± 1.2 for PETunion/CT (p < 0.0001) was noted. In liver, a mean Δbin of 0.0 ± 1.1 for PETunion/MRI and 1.7 ± 1.2 for PETunion/CT was observed (p = 0.0078). In bone, a mean Δbin closer to zero was observed for PETunion/MRI compared to PETunion/CT, 0.6 ± 1.4 and 2.0 ± 1.5, respectively (p = 0.0098). Conclusions Compared to SSTR PET/CT, SSTR PET/MRI had a higher patient and organ level concordance for malignant tumoral involvement and number of malignant lesions, with a clear added value in bone and liver specifically.

中文翻译：

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[68Ga]Ga-DOTATATE PET/CT 和 PET/MRI 的个体内定性和定量比较。

背景 生长抑素受体 (SSTR) 正电子发射断层扫描 (PET) 是神经内分泌肿瘤 (NET) 治疗的基石。混合 PET/磁共振成像 (MRI) 现在可用于 NET 成像，仅次于 PET/计算机断层扫描 (CT)。目的 确定 CT 或 MRI 是否是 [68Ga]Ga-DOTATATE PET 的最佳混合伙伴。设计单中心、前瞻性研究。方法 患者当天接受[68Ga]Ga-DOTATATE PET/CT 和随后的 PET/MRI，以怀疑 NET、（重新）分期或肽受体放射性核素治疗选择。以PETCT和PETMRI检测的恶性病灶联合（PETunion）为参考标准。测量了 PETunion 和 CT、PETunion 和 MRI 之间器官恶性病变检测的一致性。使用七个箱对恶性病变的数量进行分类，包含以下序数变量：0、1、2-5、6-10、11-20、>20可数和弥漫/不可数。恶性病变数量的差异是通过 PETunion 和 CT 以及 PETunion 和 MRI 之间的 bin 水平（“Δbin”）差异获得的，其中 Δbin 接近于零，意味着较高的一致性。结果 纳入 29 名患者。原发肿瘤包括 17 例胃肠胰 NET、1 例结肠神经内分泌癌、7 例肺 NET 和 2 例脑膜瘤。MRI 患者水平与 PETunion 的一致性为 96%，CT 患者水平一致性为 67% (p = 0.039)。MRI 与 PETunion 的器官水平一致性为 74%，CT 为 40% (p < 0.0001)。在骨骼中，MRI 的一致性比 CT 更高，分别为 92% 和 33% (p = 0.016)。总体而言，PETunion/MRI 的平均 Δbin 为 0.5 ± 1.1，PETunion/CT 的平均 Δbin 为 1.4 ± 1.2 (p < 0.0001)。在肝脏中，观察到 PETunion/MRI 的平均 Δbin 为 0.0 ± 1.1，PETunion/CT 的平均 Δbin 为 1.7 ± 1.2 (p = 0.0078)。在骨骼中，与 PETunion/CT 相比，PETunion/MRI 的平均 Δbin 接近于零，分别为 0.6 ± 1.4 和 2.0 ± 1.5 (p = 0.0098)。结论 与 SSTR PET/CT 相比，SSTR PET/MRI 在恶性肿瘤受累情况和恶性病灶数量方面具有更高的患者和器官水平一致性，特别是在骨和肝脏方面具有明显的附加价值。