Beiderwellen Karsten, Huebner Michael, Heusch Philipp, Grueneisen Johannes, Ruhlmann Verena, Nensa Felix, Kuehl Hilmar, Umutlu Lale, Rosenbaum-Krumme Sandra, Lauenstein Thomas C
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany,
Eur Radiol. 2014 Aug;24(8):2023-30. doi: 10.1007/s00330-014-3229-3. Epub 2014 Jun 8.
To compare [(18)F]FDG PET/MRI with PET/CT for the assessment of bone lesions in oncologic patients.
This prospective study included 67 patients with solid tumours scheduled for PET/CT with [(18)F]FDG who also underwent a whole-body PET/MRI scan. The datasets (PET/CT, PET/MRI) were rated by two readers regarding lesion conspicuity (four-point scale) and diagnostic confidence (five-point scale). Median scores were compared using the Wilcoxon test.
Bone metastases were present in ten patients (15%), and benign bone lesions in 15 patients (22%). Bone metastases were predominantly localized in the pelvis (18 lesions, 38%) and the spine (14 lesions, 29%). Benign bone lesions were exclusively osteosclerotic and smaller than the metastases (mean size 6 mm vs. 23 mm). While PET/CT allowed identification of 45 of 48 bone metastases (94%), PET/MRI allowed identification of all bone metastases (100%). Conspicuity of metastases was high for both modalities with significantly better results using PET/MRI (p < 0.05). Diagnostic confidence in lesion detection was high for both modalities without a significant difference. In benign lesions, conspicuity and diagnostic confidence were significantly higher with PET/CT (p < 0.05).
[(18)F]FDG PET/MRI shows high potential for the assessment of bone metastases by offering superior lesion conspicuity when compared to PET/CT. In hypersclerotic, benign bone lesions PET/CT still sets the reference.
• PET/MRI and PET/CT are of equal value for the identification of disease-positive patients • PET/MRI offers higher lesion conspicuity as well as diagnostic confidence • PET/MRI is an attractive new alternative for the assessment of bone metastases.
比较[¹⁸F]氟代脱氧葡萄糖正电子发射断层显像/磁共振成像（[¹⁸F]FDG PET/MRI）与正电子发射断层显像/计算机断层扫描（PET/CT）在评估肿瘤患者骨病变中的应用。
这项前瞻性研究纳入了67例计划进行[¹⁸F]FDG PET/CT检查的实体瘤患者，这些患者同时还接受了全身PET/MRI扫描。由两位阅片者对数据集（PET/CT、PET/MRI）的病变清晰度（四分制）和诊断信心（五分制）进行评分。使用Wilcoxon检验比较中位数分数。
10例患者（15%）存在骨转移，15例患者（22%）存在良性骨病变。骨转移主要位于骨盆（18处病变，38%）和脊柱（14处病变，29%）。良性骨病变均为骨硬化性，且比转移灶小（平均大小6 mm对23 mm）。PET/CT能够识别48处骨转移中的45处（94%），而PET/MRI能够识别所有骨转移（100%）。两种检查方式对转移灶的清晰度均较高，PET/MRI的结果明显更好（p < 0.05）。两种检查方式对病变检测的诊断信心均较高，无显著差异。在良性病变中，PET/CT的清晰度和诊断信心明显更高（p < 0.05）。
与PET/CT相比，[¹⁸F]FDG PET/MRI在评估骨转移方面具有很大潜力，其病变清晰度更高。在高度硬化的良性骨病变方面，PET/CT仍是参考标准。
• PET/MRI和PET/CT在识别疾病阳性患者方面具有同等价值 • PET/MRI具有更高的病变清晰度和诊断信心 • PET/MRI是评估骨转移的一种有吸引力的新选择。
