[18F]FDG PET/MRI combined with chest HRCT in early cancer detection - a retrospective study of 3020 asymptomatic subjects

Sep 24, 2026

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Purpose PET/MRI has become an important medical imaging approach in clinical practice. This study retrospectively assessed the detectability of fluorine-18 ([18F]FDG) PET/MRI combined with chest CT for early cancer in a large cohort of asymptomatic subjects. Methods included 3020 asymptomatic individuals undergoing whole-body [18F]FDG PET/MRI and chest HRCT, followed for 2–4 years. Detection metrics and predictive values were calculated for combined imaging versus PET/MRI alone, and PET/MRI in non-lung cancers. Results and conclusions summarize diagnostic performance.

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CategoryHealthcare

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European Journal of Nuclear Medicine and Molecular Imaging (2023) 50:3723–3734 [https://doi.org/10.1007/s00259-023-06273-6](https://doi.org/10.1007/s00259-023-06273-6) [ 18 F]FDG PET/MRI combined with chest HRCT in early cancer detection: a retrospective study of 3020 asymptomatic subjects Liling Peng1 · Yi Liao2,3,4 · Rui Zhou2,3,4 · Yan Zhong2,3,4 · Han Jiang2,3,4 · Jing Wang2,3,4 · Yu Fu5 · Le Xue2,3,4,6 · Xiaohui Zhang2,3,4 · Mingxiang Sun1 · Gang Feng1 · Zhaoting Meng1 · Sisi Peng1 · Xuexin He7 · Gaojun Teng8 · Xin Gao1 · Hong Zhang2,3,4,9,10 · Mei Tian2,3,4,6 Received: 13 March 2023 / Accepted: 18 May 2023 / Published online: 4 July 2023 © The Author(s) 2023, corrected publication 2023 Abstract Purpose PET/MRI has become an important medical imaging approach in clinical practice. In this study, we retrospectively investigated the detectability of fluorine-18 ( 18F)-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ([18F]FDG PET/MRI) combined with chest computerized tomography (CT) for early cancer in a large cohort of asymptomatic subjects. Methods This study included a total of 3020 asymptomatic subjects who underwent whole-body [ 18F]FDG PET/MRI and chest HRCT examinations. All subjects received a 2–4-year follow-up for cancer development. Cancer detection rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the [ 18F]FDG PET/MRI with or without chest HRCT were calculated and analyzed. Results Sixty-one subjects were pathologically diagnosed with cancers, among which 59 were correctly detected by [ 18F] FDG PET/MRI combined with chest HRCT. Of the 59 patients (32 with lung cancer, 9 with breast cancer, 6 with thyroid cancer, 5 with colon cancer, 3 with renal cancer, 1 with prostate cancer, 1 with gastric cancer, 1 with endometrial cancer, and 1 with lymphoma), 54 (91.5%) were at stage 0 or stage I (according to the 8th edition of the tumor-node-metastasis [TNM] staging system), 33 (55.9%) were detected by PET/MRI alone (27 with non-lung cancers and 6 with lung cancer) . Cancer detection rate, sensitivity, specificity, PPV, and NPV for PET/MRI combined with chest CT were 2.0%, 96.7%, 99.6%, 83.1%, and 99.9%, respectively. For PET/MRI alone, the metrics were 1.1%, 54.1%, 99.6%, 73.3%, and 99.1%, respectively, and for PET/MRI in non-lung cancers, the metrics were 0.9%, 93.1%, 99.6%, 69.2%, and 99.9%, respectively. Liling Peng, Yi Liao, Rui Zhou, Yan Zhong, Han Jiang, and Jing Wang contributed equally to this article. * * * 1 2 3 4 Xin Gao [george.ssmu@163.com](george.ssmu@163.com) Hong Zhang [hzhang21@zju.edu.cn](hzhang21@zju.edu.cn)[ ](hzhang21@zju.edu.cn)Mei Tian [tianmei@fudan.edu.cn](tianmei@fudan.edu.cn) Shanghai Universal Medical Imaging Diagnostic Center, Shanghai, China Department of Nuclear Medicine and PET-CT Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, Hangzhou, China Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China 5 College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, China 6 Human Phenome Institute, Fudan University, Shanghai, China 7 Department of Oncology, Huashan Hospital, Fudan University, Shanghai, China 8 Radiology Department, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China 9 Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Zhejiang, Hangzhou, China 10 The College of Biomedical Engineering and Instrument Science, Zhejiang University, Zhejiang, Hangzhou, China Conclusions [ 18F]FDG PET/MRI holds great promise for the early detection of non-lung cancers, while it seems insufficient for detecting early-stage lung cancers. Chest HRCT can be complementary to whole-body PET/MRI for early cancer detection. Trial

FAQs

What imaging methods were compared for early cancer detection?

The study compared whole-body [18F]FDG PET/MRI combined with chest CT/HRCT versus PET/MRI alone, and also evaluated PET/MRI performance specifically for non-lung cancers.

How many asymptomatic subjects were included and how long were they followed?

A total of 3020 asymptomatic subjects were included, and all underwent follow-up for 2–4 years to monitor cancer development.

What were the main diagnostic performance results for the combined approach?

For PET/MRI combined with chest CT, the cancer detection rate was 2.0% with high sensitivity (96.7%), specificity (99.6%), and NPV (99.9%), while PPV was 83.1%.

Sep 24, 2026

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