Department of Radiodiagnosis, Tata Memorial Centre, Parel, Mumbai, India.
Bio-Imaging Unit, Tata Memorial Centre, Parel, Mumbai, India.
Clin Radiol. 2014 Sep;69(9):900-8. doi: 10.1016/j.crad.2014.04.006. Epub 2014 May 23.
To assess the diagnostic accuracy of whole-body magnetic resonance imaging (WB-MRI) for metastatic disease in patients with solid small round cell tumours (SRCT) by comparing it with routine staging procedures (standard of care).
Eligible cases of neuroblastoma, primitive neuroectodermal tumour, and rhabdomyosarcoma were enrolled in the study after obtaining informed consent. WB-MRI was undertaken using overlapping coronal T1 and short-tau inversion recovery (STIR) sequences. Lesions were classified into skeletal, pulmonary, and soft-tissue types. Conventional staging, which consisted of combined positron-emission tomography & computed tomography (PET-CT), bone scintigraphy & bone marrow biopsy for bone metastases, CT thorax for lung metastases, combined PET-CT, metaiodobenzylguanidine (MIBG) scintigraphy (in neuroblastoma) for soft tissue metastases and clinical evaluation was used as the reference standard. Parameters for diagnostic accuracy were calculated.
Thirty-four out of forty patients enrolled were included in final analysis, half of them having metastatic disease. The sensitivity, specificity, positive and negative predictive value, and the diagnostic accuracy of WB-MRI and PET-CT for skeletal metastases as compared to reference standard were 91.9%, 99.8%, 97.4%, 99.6%, and 95.5% and 99.1%, 99.9%, 99.1%, 99.9%, and 99.9%, respectively. The sensitivity of MRI, only PET and PET-CT with plain CT thorax was 30%, 40%, and 100%, respectively, for lung metastases. The sensitivity of MRI for soft-tissue lesions was 76.9%.
WB-MRI is a radiation-free tool with high diagnostic accuracy for the evaluation of metastatic disease to the marrow. The rate of detection of soft-tissue metastases, such as nodal metastases, is less when WB-MRI is compared with conventional staging using coronal STIR images. CT thorax is essential for accurate evaluation of lung metastases.
通过与常规分期程序（标准护理）比较，评估全身磁共振成像（WB-MRI）在诊断实体小圆细胞肿瘤（SRCT）患者转移性疾病中的准确性。
在获得知情同意后，研究纳入神经母细胞瘤、原始神经外胚层肿瘤和横纹肌肉瘤的合格病例。采用重叠冠状 T1 和短反转恢复（STIR）序列进行 WB-MRI。病变分为骨骼、肺部和软组织类型。常规分期包括正电子发射断层扫描和计算机断层扫描（PET-CT）、骨扫描和骨髓活检用于骨转移、胸部 CT 用于肺转移、PET-CT 联合、间碘苄胍（MIBG）闪烁扫描（神经母细胞瘤）用于软组织转移和临床评估作为参考标准。计算诊断准确性的参数。
在最终分析中，纳入了 40 名患者中的 34 名，其中一半有转移性疾病。与参考标准相比，WB-MRI 和 PET-CT 对骨骼转移的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 91.9%、99.8%、97.4%、99.6%和 95.5%和 99.1%、99.9%、99.1%、99.9%和 99.9%。MRI、仅 PET 和 PET-CT 加平扫 CT 胸部的敏感性分别为 30%、40%和 100%，用于检测肺转移。MRI 对软组织病变的敏感性为 76.9%。
WB-MRI 是一种无辐射的工具，具有较高的诊断准确性，可用于评估骨髓转移。与使用冠状 STIR 图像进行常规分期相比，WB-MRI 检测淋巴结转移等软组织转移的检出率较低。胸部 CT 对准确评估肺转移至关重要。
