Fusion of PET and MRI for staging of uterine cervical cancer: comparison with contrast-enhanced 18F-FDG PET/CT and pelvic MRI

Published:February 18, 2014DOI:



      To investigate the fusion of pelvic magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (PET) for assessment of locoregional extension and nodal staging of cervical cancer.


      PET/computed tomography (CT), MRI, and non-fused and fusion of PET and MRI for assessing the extent of the primary tumor and metastasis to nodes were evaluated.


      Accuracy for T-status was 83.3% for fused and non-fused PET/MRI and MRI proved significantly more accurate than PET/CT (53.3%) (P=.0077). Sensitivity, specificity, and accuracy for nodal metastasis were 92.3%, 88.2%, and 90.0% for fused PET/MRI and PET/contrast-enhanced CT; 84.6%, 94.1%, and 90.0% for non-fused PET/MRI; and 69.2%, 100%, and 86.7% for MRI.


      Fused PET/MRI combines the individual advantages of MRI and PET.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Townsend DW
        Dual-modality imaging: combining anatomy and function.
        J Nucl Med. 2008; 49: 938-955
        • von Schulthess GK
        • Steinert HC
        • Hany TF
        Integrated PET/CT: current applications and future directions.
        Radiology. 2006; 238: 405-422
        • Kim SK
        • Choi HJ
        • Park SY
        • Lee HY
        • Seo SS
        • Yoo CW
        • Jung DC
        • Kang S
        • Cho KS
        Additional value of MR/PET fusion compared with PET/CT in the detection of lymph node metastases in cervical cancer patients.
        Eur J Cancer. 2009; 45: 2103-2109
        • Nakajo K
        • Tatsumi M
        • Inoue A
        • Isohashi K
        • Higuchi I
        • Kato H
        • Imaizumi M
        • Enomoto T
        • Shimosegawa E
        • Kimura T
        • Hatazawa J
        Diagnostic performance of fluorodeoxyglucose positron emission tomography/magnetic resonance imaging fusion images of gynecological malignant tumors: comparison with positron emission tomography/computed tomography.
        Jpn J Radiol. 2010; 28: 95-100
        • Kitajima K
        • Suenaga Y
        • Ueno Y
        • Kanda T
        • Maeda T
        • Takahashi S
        • Ebina Y
        • Miyahara Y
        • Yamada H
        • Sugimura K
        Value of fusion of PET and MRI for staging of endometrial cancer: comparison with 18F-FDG contrast-enhanced PET/CT and dynamic contrast-enhanced pelvic MRI.
        Eur J Radiol. 2013; 82: 1672-1676
        • Balleyguier C
        • Sala E
        • Da Cunha T
        • Bergman A
        • Brkljacic B
        • Danza F
        • Forstner R
        • Hamm B
        • Kubik-Huch R
        • Lopez C
        • Manfredi R
        • McHugo J
        • Oleaga L
        • Togashi K
        • Kinkel K
        Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology.
        Eur Radiol. 2011; 21: 1102-1110
        • Freeman SJ
        • Aly AM
        • Kataoka MY
        • Addley HC
        • Reinhold C
        • Sala E
        The revised FIGO staging system for uterine malignancies: implications for MR imaging.
        Radiographics. 2012; 32: 1805-1827
        • Kitajima K
        • Murakami K
        • Yamasaki E
        • Kaji Y
        • Sugimura K
        Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer.
        Eur Radiol. 2009; 19: 1529-1536
        • Pecorelli S
        Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium.
        Int J Gynaecol Obstet. 2009; 105: 103-104
        • Antosen SL
        • Jensen LN
        • Loft A
        • Berthelsen AK
        • Costa J
        • Tabor A
        • Qvist I
        • Hansen MR
        • Fisker R
        • Andersen ES
        • Sperling L
        • Nielsen AL
        • Asmussen J
        • Høgdall E
        • Fagö-Olsen CL
        • Christensen IJ
        • Nedergaard L
        • Jochumsen K
        • Høgdall C
        MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer — a multicenter prospective comparative study.
        Gynecol Oncol. 2013; 128: 300-308