Hybrid 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is an established method for assessment of lung tumors and is the current standard of reference for noninvasive preoperative staging of non-small-cell lung cancer (NSCLC). The spatial connection of the two parameters and has a crucial influence on their numeric correlation. In conclusion, spatial mismatch between and is found in a considerable percentage of patients.

In the entire patient cohort, no statistically significant correlation between and was seen, while a moderate negative linear relationship ( ) between and was observed in tumors with a spatial match ( ≤ 12 mm). A considerable number of mismatch cases (65%) was also seen in a control group that underwent simultaneous PET/MRI. Spatial mismatch ( > 12 mm) between and was found in 9/25 patients.

The upper limit of the 95% confidence interval for registration accuracy of sequential PET/MRI was 12 mm, and the mean distance ( ) between - and -voxels was 14.0 mm (average of two readers). After FDG-PET and DW-MRI coregistration, values and location of - and -voxels were analyzed. The numeric correlation of the two parameters has been extensively studied, but their spatial interplay is not well understood. The minimum apparent diffusion coefficient ( ) derived from diffusion-weighted MRI (DW-MRI) and the maximum standardized uptake value ( ) of FDG-PET are markers of aggressiveness in lung cancer.

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