Schmidt Gerwin P, Baur-Melnyk Andrea, Herzog Peter, Schmid Rupert, Tiling Reinhold, Schmidt Michael, Reiser Maximilian F, Schoenberg Stefan O
Institute of Clinical Radiology, University Hospitals Munich-Grosshadern, LMU, Munich, Germany.
Invest Radiol. 2005 Dec;40(12):743-53. doi: 10.1097/01.rli.0000185878.61270.b0.
The objective of this study was to compare the accuracy in staging of various malignant tumors with whole-body magnetic resonance imaging (WB-MRI) using parallel imaging (PAT) and positron emission tomography-computed tomography (PET-CT).
In a prospective study, 41 patients withoncologic diseases underwent [F]-fluoro-2-deoxy-D-glucose PET-CT for tumor staging and WB-MRI on a 32-channel-scanner with the use of PAT. Coronal T1w and STIR sequences at 5 body levels, axial HASTE imaging of the lung, and contrast-enhanced T1w sequences of the liver, brain, and abdomen were performed. TNM stage was assessed for both modalities in a separate consensus reading using histologic results and radiologic follow up within 6 months as the standard of reference.
Three primary and 4 recurrent tumors were detected; one recurrent tumor was missed with WB-MRI. Sixty benign and 60 malignant lymph nodes were detected with a sensitivity of 98% and specificity of 83% for PET-CT and 80%/75% for WB-MRI, respectively. One hundred ninety-one malignant and 77 benign distant lesions were detected with a sensitivity/specificity of 82% for PET-CT and 96%/82% for WB-MRI. Accuracy for correct TNM staging was 96% for PET-CT and 91% for WB-MRI.
WB-MRI and PET-CT are reliable imaging modalities for tumor staging. WB-MRI is highly sensitive in detecting distant metastases; PET-CT is superior in lymph node staging. PAT makes high-resolution WB-MRI feasible within less than 1 hour.
本研究的目的是比较使用并行成像（PAT）的全身磁共振成像（WB-MRI）和正电子发射断层扫描-计算机断层扫描（PET-CT）对各种恶性肿瘤进行分期的准确性。
在一项前瞻性研究中，41例肿瘤疾病患者接受了[F]-氟-2-脱氧-D-葡萄糖PET-CT用于肿瘤分期，并在一台使用PAT的32通道扫描仪上进行了WB-MRI检查。在5个身体层面进行了冠状位T1w和STIR序列、肺部的轴位HASTE成像以及肝脏、脑和腹部的对比增强T1w序列检查。使用组织学结果和6个月内的放射学随访作为参考标准，通过单独的共识解读对两种检查方式的TNM分期进行评估。
检测到3个原发性肿瘤和4个复发性肿瘤；WB-MRI漏诊了1个复发性肿瘤。检测到60个良性和60个恶性淋巴结，PET-CT的敏感性为98%，特异性为83%，WB-MRI的敏感性/特异性分别为80%/75%。检测到191个恶性和77个良性远处病变，PET-CT的敏感性/特异性为82%，WB-MRI为96%/82%。PET-CT正确TNM分期的准确率为96%，WB-MRI为91%。
WB-MRI和PET-CT是用于肿瘤分期的可靠成像方式。WB-MRI在检测远处转移方面高度敏感；PET-CT在淋巴结分期方面更具优势。PAT使在不到1小时内完成高分辨率WB-MRI检查成为可能。
