Department of Nuclear Medicine, Université Paris 13, CHU Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France.
Eur Radiol. 2012 Jul;22(7):1479-87. doi: 10.1007/s00330-012-2397-2. Epub 2012 Feb 24.
To assess the accuracy of FDG-PET/CT and MR with diffusion-weighted imaging (MR-DWI) for diagnosing peritoneal carcinomatosis (PC) from gastrointestinal malignancies.
Thirty consecutive patients referred for staging of gastrointestinal malignancy underwent FDG-PET/CT and MR-DWI in this retrospective study. Extent of PC was characterised by dividing the peritoneal cavity into three sites in each patient: right and left supramesocolic areas and inframesocolic level (total 90 sites). Presence of PC was confirmed either by surgery (18/30) or by follow-up (12/30).
PC was confirmed in 19 patients (19/30). At a total of 90 sites, 27 showed proven PC. On a patient-based analysis, sensitivity, specificity, PPV, NPV and accuracy were respectively 84%, 73%, 84%, 73% and 80% for PET/CT and 84%, 82%, 89%, 75% and 83% for MR-DWI. On a site-based analysis, overall sensitivity and specificity of PET/CT (63%, 90%) and MR-DWI (74%, 97%) were not statistically different (P = 0.27). In the supramesocolic area, MR-DWI detected more sites involved than PET/CT (7/9 vs. 4/9). The sensitivities of PET and MR were lower for subcentimetre tumour implants (42%, 50%). Interobserver agreement was very good for PET/CT and good for MR-DWI.
FDG-PET/CT and MR-DWI showed similar high accuracy in diagnosing PC. Both techniques underestimated the real extent of PC because of decreased sensitivity for subcentimetre lesions.
FDG-PET/CT and MR-DWI showed similar high accuracy for diagnosing peritoneal carcinomatosis. • In the supramesocolic area, MR-DWI could be more sensitive than PET/CT. • Both techniques showed lower sensitivity for subcentimetre lesions. • Interobserver agreement was very good for PET/CT and good for MR-DWI.
评估氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）与磁共振弥散加权成像（MR-DWI）诊断胃肠道恶性肿瘤腹膜转移（PC）的准确性。
本回顾性研究纳入了 30 例连续就诊于胃肠道恶性肿瘤的患者，他们均接受了 FDG-PET/CT 和 MR-DWI 检查。在每位患者中，将腹膜腔分为三个部位：右、左上腹腔和中腹腔（共 90 个部位），对 PC 的程度进行了特征描述。通过手术（18/30）或随访（12/30）确定 PC 的存在。
19 例患者（19/30）被证实患有 PC。在总共 90 个部位中，27 个部位证实存在 PC。基于患者的分析，PET/CT 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 84%、73%、84%、73%和 80%，MR-DWI 的相应值分别为 84%、82%、89%、75%和 83%。基于部位的分析显示，PET/CT（63%，90%）和 MR-DWI（74%，97%）的总体敏感性和特异性无统计学差异（P=0.27）。在上腹腔，MR-DWI 检测到的受累部位多于 PET/CT（7/9 比 4/9）。PET 和 MR 对亚厘米肿瘤种植的敏感性较低（42%，50%）。PET/CT 和 MR-DWI 的观察者间一致性均非常好。
FDG-PET/CT 和 MR-DWI 在诊断 PC 方面具有相似的高准确性。由于对亚厘米病变的敏感性降低，两种技术均低估了 PC 的真实程度。
FDG-PET/CT 和 MR-DWI 对诊断腹膜转移具有相似的高准确性。在腹腔，MR-DWI 可能比 PET/CT 更敏感。两种技术对亚厘米病变的敏感性较低。PET/CT 和 MR-DWI 的观察者间一致性均非常好。
