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In this issue of theEuropean Journal of Nuclear Medicine and Molecular Imaging, Binse and colleagues report the results of I PET/MRI in comparison with those of I PET/CT in patients with differentiated thyroid cancer (DTC). The two separate PET acquisitions explored the neck, 24 h after I intake. This elegant study showed the superiority of the PET component associated with the MRI device over the PET component associated with the CT device as it detected more iodine-positive metastases (72 vs. 60 tumour lesions, p=0.002) and identified additional patients with at least one tumour lesion (21/65 vs. 17/65 patients, p=n.s.) using a 2-min acquisition time. The assumed explanation was better lesionto-background contrast due to an improved PET device (better geometry of the detector systems and sensitive area of the crystals), which allowed better detection of thyroid tumour foci, taking advantage of their unique prolonged I accumulation. In fact, two acquisitions were performed with PET/ MRI: a 30-minute PET acquisition covered the neck MRI acquisition time and increased the detection rate of tumour lesions by 22 % in comparison with the previously cited 2min PET acquisition (88 vs. 72, p=0.07). The conclusion of this study was that I PET/MRI shows no substantial advantage over I PET/CT for the detection of tumour lesions in the neck when using similar PET devices and that the MRI component does not significantly improve sensitivity or specificity in the detection of neck lesions as compared to the CT component.

Evaluation of 124I PET/CT and 124I PET/MRI in the management of patients with differentiated thyroid cancer