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To the Editor: Dr Antoch and colleagues¹ reported that combined whole-body positron emission tomography and computed tomography (PET/CT) had greater diagnostic accuracy for cancer staging than did whole-body magnetic resonance imaging (MRI). I believe, however, that the authors' use of the term whole body is misleading, as their axial scanning range for both PET/CT and MRI did not appear to examine the brain, skull, or lower extremities. Lung cancer, for instance, commonly metastasizes to the brain. Furthermore, contrast-enhanced MRI has been reported to have higher sensitivity and specificity for brain metastases than PET.² Although true whole-body PET requires additional time for image acquisition, it may provide a more accurate staging.

Financial Disclosure: Dr Osman has received honoraria from Petnet Pharmaceuticals and Shared Medical Services.

Medhat M. Osman , MD, ScM, PhD
Department of Internal Medicine
Saint Louis University
Saint Louis, Mo

1. Antoch G, Vogt FM, Freudenberg LS, et al. Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA. 2003;290:3199-3206. FREE FULL TEXT 2. Rohern EM, Provenzale JM, Barboriak DP, et al. Screening for cerebral metastases with FDG PET in patients undergoing whole-body staging of non-central nervous system malignancy. Radiology. 2003;226:181-187. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:1320.

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