Evaluation of Neuroendocrine Liver Metastases A Comparison of Dynamic Contrast-Enhanced Magnetic Resonance Imaging and Positron Emission Tomography/Computed Tomography

Objectives The objective of this study was to evaluate the correlation between dynamic gadoxetic acid-enhanced magnetic resonance imaging parameters and specific uptake values (SUVs) derived from (18)fluorodeoxyglucose (F-18-FDG) and Ga-68-DOTA-Tyr(3)-octreotate (Ga-68-DOTATATE) positron emission tomography/computed tomography (PET/CT) in patients with liver metastases of neuroendocrine neoplasms. Methods A total of 42 patients with hepatic metastases of neuroendocrine neoplasms were prospectively enrolled and underwent both dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and PET/CT, using either F-18-FDG or Ga-68-DOTATATE as tracer. The DCE-MRI was performed at 3 T with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid acquiring 48 slices every 2.2 seconds for 5 minutes. Three regions of interest (ROIs) representing the liver background and up to 3 ROIs representing metastatic liver tissue were coregistered in the PET/CT and in the DCE-MRI data sets. For each patient, a dedicated dual-inlet, 2-compartment uptake model was fitted to the enhancement curves of DCE-MRI ROIs and perfusion parameters were calculated. Lesion-to-background ratios of SUVs were correlated with corresponding lesion-to-background ratios of the perfusion parameters arterial plasma flow, venous plasma flow, total plasma flow, extracellular mean transit time, extracellular volume, arterial flow fraction, intracellular uptake rate, and hepatic uptake fraction using the Spearman coefficient. Results Whereas the lesion-to-background ratios of arterial plasma flow and arterial flow fraction of liver metastases correlated negatively with the lesion-to-background ratios of SUVmean derived from Ga-68-DOTATATE PET/CT (r = -0.54, P < 0.001; r = -0.39, P < 0.001, respectively), they correlated positively with the lesion-to-background ratios of SUVmean derived from F-18-FDG-PET/CT (r = 0.51, P < 0.05; r = 0.68, P < 0.01, respectively). The lesion-to-background ratios of the DCE-MRI parameters extracellular mean transit time and extracellular volume correlated very weakly with the lesion-to-background ratios of SUVmean from Ga-68-DOTATATE PET/CT, whereas venous plasma flow, total plasma flow, hepatic uptake fraction, and intracellular uptake rate showed no correlation between DCE-MRI and PET/CT. Conclusions Both Ga-68-DOTATATE and (18)fluorodeoxyglucose PET/CT partially correlate with MRI perfusion parameters from the dual-inlet, 2-compartment uptake model. The results indicate that the paired imaging methods deliver complementary functional information.