PET/MRI integrates anatomic and functional MRI data with the metabolic information of PET. Interest around PET/MRI includes functional information and higher soft-tissue contrast resolution. An international survey of active whole- body PET/MRI sites showed oncology as its main application. Perceived challenges to its widespread use included study duration (2 times longer than a typical PET/CT), lack of standardized protocols, and challenges with interpretation (>80% sites had radiologist and nuclear medicine physicians jointly reporting as opposed to 40% for PET/CT) [46]. When imaging the lungs, PET/MRI faces the same challenges as lung MRI. Small nonavid nodules are usually missed, and finding precise anatomic correlates for areas of lung uptake can be difficult. 9 Incidentally Detected Indeterminate Pulmonary Nodule 21.4% of the missed nodules were rated malignant. This resulted in one patient being upstaged from tumor stage I to IV [50]. Further advances on PET/MRI are needed before it is implemented in clinical practice, and current research points toward its use in oncology as opposed to incidental pulmonary nodule characterization. The most common complication of TNB is pneumothorax, and rates vary in series based on technique and study design. Two meta-analysis reported pooled rates of pneumothorax and hemoptysis of 19% to 25.3% and 4.1% to 12%, respectively [52,56]. Other studies report pneumothorax in 16% to 45% of cases and pneumothorax requiring a chest tube in 1.8% to 15% [52,53,56]. A meta-analysis of 46 studies from 2010-2015 described complication rates of CT-guided core-needle and FNA biopsy. They found that minor complications were more common in FNA, major complications were rare, and that smaller nodules, larger needle diameter, and increased transverse lung were risk factors for FNA complications. Complication rate for core biopsy was 38.8% versus 24.0% for FNA (P < . 001).
Incidentally Detected Indeterminate Pulmonary Nodule PCAs. PET/MRI integrates anatomic and functional MRI data with the metabolic information of PET. Interest around PET/MRI includes functional information and higher soft-tissue contrast resolution. An international survey of active whole- body PET/MRI sites showed oncology as its main application. Perceived challenges to its widespread use included study duration (2 times longer than a typical PET/CT), lack of standardized protocols, and challenges with interpretation (>80% sites had radiologist and nuclear medicine physicians jointly reporting as opposed to 40% for PET/CT) [46]. When imaging the lungs, PET/MRI faces the same challenges as lung MRI. Small nonavid nodules are usually missed, and finding precise anatomic correlates for areas of lung uptake can be difficult. 9 Incidentally Detected Indeterminate Pulmonary Nodule 21.4% of the missed nodules were rated malignant. This resulted in one patient being upstaged from tumor stage I to IV [50]. Further advances on PET/MRI are needed before it is implemented in clinical practice, and current research points toward its use in oncology as opposed to incidental pulmonary nodule characterization. The most common complication of TNB is pneumothorax, and rates vary in series based on technique and study design. Two meta-analysis reported pooled rates of pneumothorax and hemoptysis of 19% to 25.3% and 4.1% to 12%, respectively [52,56]. Other studies report pneumothorax in 16% to 45% of cases and pneumothorax requiring a chest tube in 1.8% to 15% [52,53,56]. A meta-analysis of 46 studies from 2010-2015 described complication rates of CT-guided core-needle and FNA biopsy. They found that minor complications were more common in FNA, major complications were rare, and that smaller nodules, larger needle diameter, and increased transverse lung were risk factors for FNA complications. Complication rate for core biopsy was 38.8% versus 24.0% for FNA (P < . 001).