An international expert opinion statement on the utility of PET/MR for imaging of skeletal metastases

Jad S. Husseini, Bárbara Juarez Amorim, Angel Torrado-Carvajal, Vinay Prabhu, David Groshar, Lale Umutlu, Ken Herrmann, Lina García Cañamaque, José Ramón García Garzón, William E. Palmer, Pedram Heidari, Tiffany Ting Fang Shih, Jacob Sosna, Cristina Matushita, Juliano Cerci, Marcelo Queiroz, Valdair Francisco Muglia, Marcello H. Nogueira-Barbosa, Ronald J.H. Borra, Thomas C. KweeAndor W.J.M. Glaudemans, Laura Evangelista, Marco Salvatore, Alberto Cuocolo, Andrea Soricelli, Christian Herold, Andrea Laghi, Marius Mayerhoefer, Umar Mahmood, Ciprian Catana, Heike E. Daldrup-Link, Bruce Rosen, Onofrio A. Catalano*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: MR is an important imaging modality for evaluating musculoskeletal malignancies owing to its high soft tissue contrast and its ability to acquire multiparametric information. PET provides quantitative molecular and physiologic information and is a critical tool in the diagnosis and staging of several malignancies. PET/MR, which can take advantage of its constituent modalities, is uniquely suited for evaluating skeletal metastases. We reviewed the current evidence of PET/MR in assessing for skeletal metastases and provided recommendations for its use. Methods: We searched for the peer reviewed literature related to the usage of PET/MR in the settings of osseous metastases. In addition, expert opinions, practices, and protocols of major research institutions performing research on PET/MR of skeletal metastases were considered. Results: Peer-reviewed published literature was included. Nuclear medicine and radiology experts, including those from 13 major PET/MR centers, shared the gained expertise on PET/MR use for evaluating skeletal metastases and contributed to a consensus expert opinion statement. [18F]-FDG and non [18F]-FDG PET/MR may provide key advantages over PET/CT in the evaluation for osseous metastases in several primary malignancies. Conclusion: PET/MR should be considered for staging of malignancies where there is a high likelihood of osseous metastatic disease based on the characteristics of the primary malignancy, hight clinical suspicious and in case, where the presence of osseous metastases will have an impact on patient management. Appropriate choice of tumor-specific radiopharmaceuticals, as well as stringent adherence to PET and MR protocols, should be employed.

Original languageAmerican English
Pages (from-to)1522-1537
Number of pages16
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number5
StatePublished - May 2021

Bibliographical note

Funding Information:
A Torrado-Carvajal declares no conflicts of interest. The work by Dr. Torrado-Carvajal was partially supported by Young Reserchers R&D Project Ref M2166 (MIMC3-PET/MR) financed by Community of Madrid and Rey Juan Carlos University. Dr. Umutlu receives speaker and consultant payments from Bayer Healthcare and Siemens Healthcare, and research funds from Siemens. Dr. Herrmann has received personal fees from Bayer, Sofie Biosciences, SIRTEX, Adacap, Curium, Endocyte, IPSEN, Siemens Healthineers, GE Healthcare, and Amgen; non-financial support from ABX; personal fees from grants; and personal fees from BTG, outside the submitted work. Dr. Queiroz received research support from GE Healthcare. Dr. Herold is a member of scientific advisory board of Siemens Healthineers. He is also a recipient of grants/research support from Siemens Healthineers, Bayer Healthcare, Bracco (through contract with his University). Dr. Laghi has received honoraria for invited lectures from Bracco, GE Healthcare, Bayer, Guerbet and Merck. Dr. Mayerhoefer has received speaker honoraria from Bristol Myers Squibb and Siemens (paid to him), and research support from Siemens Healthineers (paid to his institution). Dr. Mahmood is a cofounder/shareholder, consultant, and grant recipient of CytoSite Biopharma. Dr. Catana has ongoing relationships with Siemens Healthineers in the domain of PET/MRI hardware and software development. Dr. Daldrup-Link receives research support from the Andrew McDonough B+ Foundation and from the Sarcoma Foundation. Dr. Rosen did not receive any personal support. However, the Martinos center receives research support from Siemens Healthineers and GE Healthcare. Dr. Catalano has been a consultant for Siemens Healthineers and IBM and receives research support from Bayer. He is a recipient of an IBM fellowship. The Martinos center receives research support from Siemens Healthineers and GE Healthcare. J Husseini, B Juarez Amorim, V Prabhu, D Groshar, L. García Cañamaque, J. García Garzón, W. Palmer, P. Heidari, T. Ting-Fang Shih, J. Sosna, C. Matushita, J. Cerci, V. Muglia, M. Nogueira-Barbosa, R. Borra, T. Kwee, A. Glaudemans, L. Evangelista, M. Salvatore, A. Cuocolo, and A. Soricelli declare no competing interests.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.


  • MR
  • Metastases
  • Osseous
  • PET
  • PET/MR
  • Skeletal
  • MRI


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