Schaarschmidt Benedikt, Buchbender Christian, Gomez Benedikt, Rubbert Christian, Hild Florian, Köhler Jens, Grueneisen Johannes, Reis Henning, Ruhlmann Verena, Wetter Axel, Quick Harald H, Antoch Gerald, Heusch Philipp
Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany,
Eur J Nucl Med Mol Imaging. 2015 Jul;42(8):1257-67. doi: 10.1007/s00259-015-3050-5. Epub 2015 Apr 8.
To compare the accuracy of different MR sequences in simultaneous PET/MR imaging for T staging in non-small-cell lung cancer in relation to histopathology.
The study included 28 patients who underwent dedicated thoracic PET/MR imaging before tumour resection. Local tumour staging was performed separately by three readers with each of the following MR sequences together with PET: transverse T2 BLADE, transverse non-enhanced and contrast-enhanced T1 FLASH, T1 3D Dixon VIBE in transverse and coronal orientation, coronal T2 HASTE, and coronal TrueFISP. The staging results were compared with histopathology after resection as the reference standard. Differences in the accuracy of T staging among the MR sequences were evaluated using McNemar's test. Due to multiple testing, Bonferroni correction was applied to prevent accumulation of α errors; p < 0.0024 was considered statistically significant.
Compared with histopathology, T-staging accuracy was 69% with T2 BLADE, 68% with T2 HASTE, 59% with contrast-enhanced T1 FLASH, 57% with TrueFISP, 50 % with non-enhanced T1 FLASH, and 45% and 48% with T1 3D Dixon VIBE in transverse and coronal orientation, respectively. Staging accuracy with T2 BLADE was significantly higher than with non-enhanced T1 FLASH and with T1 3D Dixon VIBE in transverse and coronal orientations (p < 0.0024). T2 HASTE had a significantly higher T-staging accuracy than transverse T1 3D-Dixon-VIBE (p < 0.0024).
Transverse T2 BLADE images provide the highest accuracy for local tumour staging and should therefore be included in dedicated thoracic PET/MR protocols. As T1 3D Dixon VIBE images acquired for attenuation correction performed significantly worse, this sequence cannot be considered sufficiently accurate for local tumour staging in the thorax.
比较在同时进行的PET/MR成像中，不同MR序列用于非小细胞肺癌T分期的准确性，并与组织病理学结果进行对比。
本研究纳入了28例在肿瘤切除术前接受专门的胸部PET/MR成像检查的患者。由三位阅片者分别使用以下每种MR序列结合PET进行局部肿瘤分期：横轴位T2 BLADE、横轴位非增强及增强T1 FLASH、横轴位和冠状位T1 3D Dixon VIBE、冠状位T2 HASTE以及冠状位TrueFISP。将分期结果与切除术后的组织病理学结果作为参考标准进行比较。使用McNemar检验评估各MR序列在T分期准确性上的差异。由于进行了多次检验，采用Bonferroni校正以防止α错误的累积；p < 0.0024被认为具有统计学意义。
与组织病理学相比，T2 BLADE的T分期准确率为69%，T2 HASTE为68%，增强T1 FLASH为59%，TrueFISP为57%，非增强T1 FLASH为50%，横轴位和冠状位T1 3D Dixon VIBE分别为45%和48%。T2 BLADE的分期准确率显著高于非增强T1 FLASH以及横轴位和冠状位T1 3D Dixon VIBE（p < 0.0024）。T2 HASTE的T分期准确率显著高于横轴位T1 3D-Dixon-VIBE（p < 0.0024）。
横轴位T2 BLADE图像在局部肿瘤分期中提供了最高的准确性，因此应纳入专门的胸部PET/MR检查方案中。由于用于衰减校正的T1 3D Dixon VIBE图像表现明显较差，该序列不能被认为在胸部局部肿瘤分期中具有足够的准确性。
