用于淋巴瘤患者评估的PET/MRI：初步观察结果
PET/MRI for the evaluation of patients with lymphoma: initial observations.
作者信息
Heacock Laura, Weissbrot Joseph, Raad Roy, Campbell Naomi, Friedman Kent P, Ponzo Fabio, Chandarana Hersh
机构信息
1 Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY 10016.
出版信息
AJR Am J Roentgenol. 2015 Apr;204(4):842-8. doi: 10.2214/AJR.14.13181.
OBJECTIVE
The objective of our study was to assess the role of recently introduced hybrid PET/MRI in the evaluation of lymphoma patients using PET/CT as a reference standard.
SUBJECTS AND METHODS
In this prospective study 28 consecutive lymphoma patients (18 men, 10 women; mean age, 53.6 years) undergoing clinically indicated PET/ CT were subsequently imaged with PET/MRI using residual FDG activity from the PET/ CT study. Blinded readers evaluated PET/CT (reference standard), PET/MRI, and diffusion-weighted imaging (DWI) studies separately; for each study, they assessed nodal and extranodal involvement. Each FDG-avid nodal station was marked and compared on DWI, PET/MRI, and PET/CT. Modified Ann Arbor staging was performed and compared between PET/MRI and PET/CT. The maximum standardized uptake value (SUVmax) on PET/MRI for FDG-avid nodal lesions was compared with the SUVmax on PET/CT. The apparent diffusion coefficient (ADC) for FDG-avid nodal lesions was compared to SUVmax on PET/MRI.
RESULTS
Fifty-one FDG-avid nodal groups were identified on PET/CT in 13 patients. PET/MRI identified 51 of these nodal groups with a sensitivity of 100%. DWI identified 32 nodal groups for a sensitivity of 62.7%. PET/MRI staging and PET/CT staging were concordant in 96.4% of patients. For the one patient with discordant staging results, disease was correctly upstaged to stage IV on the basis of the PET/MRI finding of bone marrow involvement, which was missed on PET/CT. DWI staging was concordant with PET/CT staging in 64.3% of the patients. The increased staging accuracy of PET/MRI relative to DWI was significant (p=0.004). SUVmax measured on PET/MRI and PET/CT showed excellent statistically significant correlation (r=0.98, p<0.001). There was a poor negative correlation between ADC and SUVmax (r=-0.036, p=0.847).
CONCLUSION
PET/MRI can be used to assess disease burden in lymphoma with sensitivity similar to PET/CT and can be a viable alternative for lymphoma staging and follow-up.
目的
本研究的目的是使用PET/CT作为参考标准，评估最近引入的PET/MRI在淋巴瘤患者评估中的作用。
对象与方法
在这项前瞻性研究中，28例连续的淋巴瘤患者（18例男性，10例女性；平均年龄53.6岁）接受了临床指征的PET/CT检查，随后利用PET/CT检查中残留的FDG活性进行PET/MRI成像。盲法阅片者分别评估PET/CT（参考标准）、PET/MRI和扩散加权成像（DWI）检查；对于每项检查，他们评估淋巴结和结外受累情况。对每个FDG摄取阳性的淋巴结部位在DWI、PET/MRI和PET/CT上进行标记并比较。进行改良的Ann Arbor分期，并在PET/MRI和PET/CT之间进行比较。比较PET/MRI上FDG摄取阳性淋巴结病变的最大标准化摄取值（SUVmax）与PET/CT上的SUVmax。将FDG摄取阳性淋巴结病变的表观扩散系数（ADC）与PET/MRI上的SUVmax进行比较。
结果
13例患者的PET/CT上共识别出51个FDG摄取阳性的淋巴结组。PET/MRI识别出其中51个淋巴结组，敏感性为100%。DWI识别出32个淋巴结组，敏感性为62.7%。PET/MRI分期与PET/CT分期在96.4%的患者中一致。对于1例分期结果不一致的患者，根据PET/MRI发现的骨髓受累情况（PET/CT未发现），疾病被正确上调至IV期。DWI分期与PET/CT分期在64.3%的患者中一致。PET/MRI相对于DWI分期准确性的提高具有显著性（p=0.004）。PET/MRI和PET/CT上测量的SUVmax显示出极好的统计学显著相关性（r=0.98，p<0.001）。ADC与SUVmax之间存在较差的负相关性（r=-0.036，p=0.847）。
结论
PET/MRI可用于评估淋巴瘤的疾病负担，其敏感性与PET/CT相似，可作为淋巴瘤分期和随访的可行替代方法。
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