Whole-body MR imaging vs. FDG-PET: Comparison of accuracy of M-stage diagnosis for lung cancer patients

Purpose To conduct a prospective comparison of the accuracy of whole‐body MR imaging and positron emission tomography (PET) with fluorine‐18 deoxyglucose (FDG) (FDG‐PET) to assess the M‐stage in lung cancer patients. Materials and Methods A total of 90 consecutive lung cancer patients (mean age = 68 years) underwent whole‐body MR imaging and FDG‐PET as well as other standard radiological imaging procedures before and after treatment. Probabilities of metastases on whole‐body MR imaging and FDG‐PET were assessed by using 5‐point scoring systems on a per‐site basis and on a per‐patient basis. Receiver operating characteristic (ROC) curve analysis was used to compare diagnostic capabilities. Sensitivity, specificity, and accuracy were also compared by using the McNemar's test on a per‐site and per‐patient basis. Results For assessment of head and neck metastases and bone metastases, accuracies of whole‐body MR imaging (95.0% and 94.8%, respectively) were significantly higher than those of FDG‐PET (89.1% and 88.2%, respectively; P < 0.05). For assessment of the M‐stage on a per‐patient basis, accuracy of whole‐body MR imaging (80.0%) was also significantly higher than that of FDG‐PET (73.3%; P < 0.05). Conclusion Whole‐body MR imaging is an accurate diagnostic technique and may be considered at least as effective as FDG‐PET for assessment of the M‐stage of lung cancer patients. J. Magn. Reson. Imaging 2007;26:498–509. © 2007 Wiley‐Liss, Inc.