The researchers found that of the 98 patients, the overall primary tumor, regional lymph nodes, and distant metastasis (TNM) stage was correctly determined in 75 with PET/CT (77 percent) and in 53 with MRI (54 percent). "Compared with MRI, PET/CT had a direct impact on patient management in 12 patients. Results from MRI changed the therapy regimen in 2 patients compared with PET/CT. Separate assessment of [tumor]-stage (with pathological verification) in 46 patients revealed PET/CT to be accurate in 37 (80 percent) and MRI to be accurate in 24 (52 percent). Of 98 patients, [lymph node]-stage was correctly determined in 91 patients with PET/CT (93 percent) and in 77 patients with MRI (79 percent). Both imaging procedures showed a similar performance in detecting distant metastases," the authors write.

"The most crucial aspect of clinical tumor staging relates to the staging impact on patient management. Compared with whole-body MRI, the therapy regimen was altered in a substantially larger number of patients when staging analysis was based on the PET/CT data. Therefore, FDG-PET/CT can be recommended as a first-line tool for whole-body tumor staging of different oncological diseases," the researchers conclude. (JAMA. 2003;290:3199-3206. Available post-embargo at jama.com)

Editorial: Whole-Body Imaging With MRI or PET/CT - The Future for Single-Modality Imaging in Oncology? In an accompanying editorial, Lennart Blomqvist, M.D., Ph.D., and Michael R. Torkzad, M.D., of Karolinska Hospital, Stockholm, Sweden, discuss the study by Antoch et al.

"The day in which futuristic movies show a patient lying on a table, entering a tunnel-like device with blinking l
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Contact: Gerald Antoch, M.D.
gerald.antoch@uni-essen.de
JAMA and Archives Journals
23-Dec-2003