Queiroz Marcelo A, Hüllner Martin, Kuhn Felix, Huber Gerhardt, Meerwein Christian, Kollias Spyros, von Schulthess Gustav, Veit-Haibach Patrick
Department of Medical Radiology, Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland,
Eur J Nucl Med Mol Imaging. 2014 Jun;41(6):1066-75. doi: 10.1007/s00259-014-2707-9. Epub 2014 Feb 28.
Positron emission tomography (PET)/MRI combines the functional ability of PET and the high soft tissue contrast of MRI. The aim of this study was to assess contrast-enhanced (ce)PET/MRI compared to cePET/CT in patients with suspected recurrence of head and neck cancer (HNC).
Eighty-seven patients underwent sequential cePET/CT and cePET/MRI using a trimodality PET/CT-MRI set-up. Diagnostic accuracy for the detection of recurrent HNC was evaluated using cePET/CT and cePET/MRI. Furthermore, image quality, presence of unclear (18)F-fluorodeoxy-D-glucose (FDG) findings of uncertain significance and the diagnostic advantages of use of gadolinium contrast enhancement were analysed.
cePET/MRI showed no statistically significant difference in diagnostic accuracy compared to cePET/CT (91.5 vs 90.6%). Artefacts' grade was similar in both methods, but their location was different. cePET/CT artefacts were primarily located in the suprahyoid area, while on cePET/MRI, artefacts were more equally distributed among the supra and infrahyoid neck regions. cePET/MRI and cePET/CT showed 34 unclear FDG findings; of those 11 could be solved by cePET/MRI and 5 by cePET/CT. The use of gadolinium in PET/MRI did not yield higher diagnostic accuracy, but helped to better define tumour margins in 6.9% of patients.
Our data suggest that cePET/MRI may be superior compared to cePET/CT to specify unclear FDG uptake related to possible tumour recurrence in follow-up of patients after HNC. It seems to be the modality of choice for the evaluation of the oropharynx and the oral cavity because of a higher incidence of artefacts in cePET/CT in this area mainly due to dental implants. However, overall there is no statistically significant difference.
正电子发射断层扫描（PET）/磁共振成像（MRI）结合了PET的功能能力和MRI的高软组织对比度。本研究的目的是评估在疑似头颈部癌（HNC）复发患者中，对比增强（ce）PET/MRI与cePET/CT相比的情况。
87例患者使用三联PET/CT-MRI设备依次接受cePET/CT和cePET/MRI检查。使用cePET/CT和cePET/MRI评估检测复发性HNC的诊断准确性。此外，分析了图像质量、意义不确定的不明（18）F-氟脱氧-D-葡萄糖（FDG）表现的存在情况以及使用钆对比增强的诊断优势。
与cePET/CT相比，cePET/MRI在诊断准确性上无统计学显著差异（91.5%对90.6%）。两种方法中伪影等级相似，但位置不同。cePET/CT伪影主要位于舌骨上区，而在cePET/MRI上，伪影在舌骨上和舌骨下颈部区域分布更均匀。cePET/MRI和cePET/CT显示有34个不明FDG表现；其中11个可通过cePET/MRI解决，5个可通过cePET/CT解决。在PET/MRI中使用钆并未产生更高的诊断准确性，但有助于在6.9%的患者中更好地界定肿瘤边缘。
我们的数据表明，在HNC患者随访中，对于明确与可能的肿瘤复发相关的不明FDG摄取，cePET/MRI可能优于cePET/CT。由于该区域cePET/CT中伪影发生率较高，主要是由于牙种植体，它似乎是评估口咽和口腔的首选方式。然而，总体上没有统计学显著差异。
