全身 PET/MRI 和全身 PET/CT 对肿瘤 TNM 分期的诊断准确性。
Diagnostic accuracy of whole-body PET/MRI and whole-body PET/CT for TNM staging in oncology.
机构信息
Medical Faculty, Department of Diagnostic and Interventional Radiology, University Duesseldorf,, Moorenstr. 5, 40225, Duesseldorf, Germany,
出版信息
Eur J Nucl Med Mol Imaging. 2015 Jan;42(1):42-8. doi: 10.1007/s00259-014-2885-5. Epub 2014 Aug 12.
PURPOSE
In various tumours PET/CT with [(18)F]FDG is widely accepted as the diagnostic standard of care. The purpose of this study was to compare a dedicated [(18)F]FDG PET/MRI protocol with [(18)F]FDG PET/CT for TNM staging in a cohort of oncological patients.
METHODS
A dedicated [(18)F]FDG PET/MRI protocol was performed in 73 consecutive patients (mean age of 59 years, range 21 - 85 years) with different histologically confirmed solid primary malignant tumours after a routine clinical FDG PET/CT scan (60 min after injection of 295 ± 45 MBq [(18)F]FDG). TNM staging according to the 7th edition of the AJCC Cancer Staging Manual was performed by two readers in separate sessions for PET/CT and PET/MRI images. Assessment of the primary tumour and nodal and distant metastases with FDG PET/CT and FDG PET/MRI was based on qualitative and quantitative analyses. Histopathology, and radiological and clinical follow-up served as the standards of reference. A McNemar test was performed to evaluate the differences in diagnostic performance between the imaging procedures.
RESULTS
From FDG PET/CT and FDG PET/MRI T stage was correctly determined in 22 (82 %) and 20 (74 %) of 27 patients, N stage in 55 (82 %) and 56 (84 %) of 67 patients, and M stage in 32 (76 %) and 35 (83 %) of 42 patients, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for lymph node metastases were 65 %, 94 %, 79 %, 89 % and 87 % for PET/CT, and 63 %, 94 %, 80 %, 87 % and 85 % for PET/MRI. The respective values for the detection of distant metastases were 50 %, 82 %, 40 %, 88 % and 76 % for PET/CT, and 50 %, 91 %, 57 %, 89 % and 83 % for PET/MRI. Differences between the two imaging modalities were not statistically significant (P > 0.05).
CONCLUSION
According to our results, FDG PET/CT and FDG PET/MRI are of equal diagnostic accuracy for TNM staging in patients with solid tumours.
目的
在各种肿瘤中，PET/CT 联合 [(18)F]FDG 已被广泛接受为诊断标准。本研究的目的是比较专门的 [(18)F]FDG PET/MRI 方案与 [(18)F]FDG PET/CT 在肿瘤患者队列中的 TNM 分期。
方法
对 73 例不同组织学证实的原发性恶性实体瘤患者进行了专门的 [(18)F]FDG PET/MRI 方案检查（在注射 295±45MBq [(18)F]FDG 后 60 分钟）。根据第 7 版 AJCC 癌症分期手册，由两名读者分别对 PET/CT 和 PET/MRI 图像进行 TNM 分期。FDG PET/CT 和 FDG PET/MRI 对原发肿瘤、淋巴结和远处转移的评估基于定性和定量分析。组织病理学、影像学和临床随访作为参考标准。采用 McNemar 检验评价两种成像方法的诊断性能差异。
结果
27 例患者中，22 例（82%）和 20 例（74%）患者的 FDG PET/CT 和 FDG PET/MRI T 分期正确，67 例患者中 55 例（82%）和 56 例（84%）患者的 N 分期正确，42 例患者中 32 例（76%）和 35 例（83%）患者的 M 分期正确。FDG PET/CT 检测淋巴结转移的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 65%、94%、79%、89%和 87%，FDG PET/MRI 分别为 63%、94%、80%、87%和 85%。FDG PET/CT 检测远处转移的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 50%、82%、40%、88%和 76%，FDG PET/MRI 分别为 50%、91%、57%、89%和 83%。两种成像方式之间的差异无统计学意义（P>0.05）。
结论
根据我们的结果，FDG PET/CT 和 FDG PET/MRI 在肿瘤患者的 TNM 分期中具有相同的诊断准确性。
Zotero 插件