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CC BY 4.0 · World J Nucl Med 2025; 24(04): 335-345
DOI: 10.1055/s-0045-1814145
Original Article

Incremental Value of Digital PET/MRI over PET/CT in the Assessment of Neoplastic Liver Lesions

Authors

  • Pawan Gulabrao Shinkar

    1   Department of Radiology and Nuclear Medicine, Omega Hospitals, Hyderabad, Telangana, India

  • Mohana Vamsy

    2   Department of Surgical Oncology, Omega Hospitals, Hyderabad, Telangana, India

  • Dileep Kumar

    3   United Imaging Healthcare, Shanghai, People's Republic of China

  • Palak Wadhwa

    3   United Imaging Healthcare, Shanghai, People's Republic of China
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Abstract

Objectives

The objective of this study was to assess the performance of positron emission tomography/magnetic resonance imaging (PET/MRI) compared with PET/computed tomography (PET/CT) in the clinical management of patients with neoplastic hepatic lesions.

Materials and Methods

This is a retrospective study and includes a sample size of 15 patients, referred for diagnostic evaluation and staging of neoplastic hepatic lesions. The patients included in this study underwent a simultaneous PET/CT scan on uMI-Vista and a complementary liver PET/MRI scan on uPMR 790. PET/CT and PET/MRI were compared based on the number of detected lesions, the smallest detected lesion diameter, and tumor-to-liver ratio (TLR). The histopathological analysis was considered the standard of reference.

Results

PET/MRI reported extra information in 87% (13/15) of patients, and additional lesions were identified in 73% (11/15) of patients. Furthermore, PET/MRI could identify subcentimeter liver lesions and added great value in the evaluation of lesion viability. Overall, 40 additional lesions were detected with PET/MRI in contrast with PET/CT within the given patient cohort. The smallest revealed lesion measured 2 mm in the long-axis diameter, and the average long-axis diameter of small lesions detected by PET/MRI across 15 patients was 3.4 mm with a standard deviation of 1.3 mm. These findings significantly affected the final outcomes in 12 out of 15 patients, leading to modifications in the response assessment category in 5 patients and defined the malignant hepatic lesions on staging/restaging scans (10/15).

Discussion

PET/MRI has been found to outperform PET/CT in terms of conspicuity of liver lesions, with better sensitivity and specificity. Overall, coregistered PET and MR images have been shown to outperform PET/CT in the imaging of liver lesions, with better delineation of small lesions as well as reliable localization of lesions to the corresponding liver segment.

Conclusion

In addition to a significant decrease in radiation exposure, the PET/MRI combination resulted in higher detection rates and more precise characterization of small malignant liver lesions and tends to be more powerful than PET/CT, which has a direct impact on the patient's diagnosis, staging, and further therapeutic strategies.

Keywords

PET/MRI - liver lesions - molecular imaging - multimodality scanning - neoplastic hepatic lesions - PET/CT

Authors' Contributions

All authors contributed to the study's conception and design, as well as to material preparation, data collection, and analysis. All authors read and approved the final manuscript. The datasets generated or analyzed during the current study are available from the corresponding author upon reasonable request.


IRB Approval

The study involving human participants was reviewed and approved by the Institutional Review Board, Omega Hospitals, Hyderabad, India.


Informed Consent

Informed consent was obtained from all individual participants included in the study, or the requirement for written consent was waived by the Institutional Review Board.


Ethical Standards

All procedures involving human participants were conducted in accordance with the Declaration of Helsinki (revised in 2013) and its subsequent amendments.


Declaration of GenAI Use

During the preparation of this article, the authors used ChatGPT to support the writing of the introduction section. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the final version of the publication.




Publication History

Article published online:
18 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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