Kohan A A, Kolthammer J A, Vercher-Conejero J L, Rubbert C, Partovi S, Jones R, Herrmann K A, Faulhaber P
Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA,
Eur Radiol. 2013 Nov;23(11):3161-9. doi: 10.1007/s00330-013-2914-y. Epub 2013 Jun 14.
Evaluate the performance of PET/MRI at tissue interfaces with different attenuation values for detecting lymph node (LN) metastases and for accurately measuring maximum standardised uptake values (SUVmax) in lung cancer patients.
Eleven patients underwent PET/CT and PET/MRI for staging, restaging or follow-up of suspected or known lung cancer. Four experienced readers determined the N stage of the patients for each imaging method in a randomised blinded way. Concerning metastases, SUVmax of FDG-avid LNs were measured in PET/CT and PET/MRI in all patients. A standard of reference was created with a fifth experienced independent reader in combination with a chart review. Results were analysed to determine interobserver agreement, SUVmax correlation between CT and MRI (three-segment model) attenuation correction and diagnostic performance of the two techniques.
Overall interobserver agreement was high (κ = 0.86) for PET/CT and substantial (κ = 0.70) for PET/MRI. SUVmax showed strong positive correlation (Spearman's correlation coefficient = 0.93, P < 0.001) between the two techniques. Diagnostic performance of PET/MRI was slightly inferior to that of PET/CT, without statistical significance (P > 0.05).
PET/MRI using three-segment model attenuation correction for LN staging in lung cancer shows a strong parallel to PET/CT in terms of SUVmax, interobserver agreement and diagnostic performance.
•F18-FDG PET/MRI shows similar performance to F18-FDG PET/CT in lung cancer N staging. •PET/MRI has substantial interobserver agreement in N staging. •A three-segment model attenuation correction is reliable for assessing the mediastinum.
评估正电子发射断层扫描/磁共振成像（PET/MRI）在不同衰减值的组织界面处检测肺癌患者淋巴结（LN）转移及准确测量最大标准化摄取值（SUVmax）的性能。
11例患者因疑似或已知肺癌的分期、再分期或随访接受了PET/CT和PET/MRI检查。四名经验丰富的阅片者以随机盲法确定每种成像方法下患者的N分期。对于转移灶，在所有患者的PET/CT和PET/MRI中测量FDG摄取阳性淋巴结的SUVmax。由第五位经验丰富的独立阅片者结合图表回顾建立参考标准。分析结果以确定观察者间的一致性、CT和MRI之间的SUVmax相关性（三段模型）衰减校正以及两种技术的诊断性能。
PET/CT的观察者间总体一致性较高（κ = 0.86），PET/MRI的一致性为实质性（κ = 0.70）。两种技术之间的SUVmax显示出强正相关（Spearman相关系数 = 0.93，P < 0.001）。PET/MRI的诊断性能略低于PET/CT，但无统计学意义（P > 0.05）。
在肺癌LN分期中，采用三段模型衰减校正的PET/MRI在SUVmax、观察者间一致性和诊断性能方面与PET/CT表现出很强的相似性。
•F18-FDG PET/MRI在肺癌N分期中表现与F18-FDG PET/CT相似。•PET/MRI在N分期中观察者间一致性较高。•三段模型衰减校正用于评估纵隔是可靠的。
