Brendle C, Schwenzer N F, Rempp H, Schmidt H, Pfannenberg C, la Fougère C, Nikolaou K, Schraml C
Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
Nuclear Medicine, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
Eur J Nucl Med Mol Imaging. 2016 Jan;43(1):123-132. doi: 10.1007/s00259-015-3137-z. Epub 2015 Jul 31.
The purpose was to investigate the diagnostic performance of different combinations of anatomical and functional imaging techniques in PET/MRI and PET/CT for the evaluation of metastatic colorectal cancer lesions.
Image data of 15 colorectal cancer patients (FDG-PET/CT and subsequent FDG-PET/MRI) were retrospectively evaluated by two readers in five reading sessions: MRI (morphology) alone, MRI/diffusion-weighted MRI (DWI), MRI/PET, MRI/DWI/PET; and PET/CT. Diagnostic performance of lesion detection with each combination was assessed in general and organ-based. The reference standard was given by histology and/or follow-up imaging. Separate analysis of mucinous tumours was performed.
One hundred and eighty lesions (110 malignant) were evaluated (intestine n = 6, liver n = 37, lymph nodes n = 55, lung n = 4, and peritoneal n = 74). The overall lesion-based diagnostic accuracy was 0.46 for MRI, 0.47 for MRI/DWI, 0.57 for MRI/PET, 0.69 for MRI/DWI/PET and 0.66 for PET/CT. In the organ-based assessment, MRI/DWI/PET showed the highest accuracy for liver metastases (0.74), a comparable accuracy to PET/CT in peritoneal lesions (0.55), and in lymph node metastases (0.84). The accuracy in mucinous tumour lesions was limited in all modalities (MRI/DWI/PET = 0.52).
PET/MRI including DWI is comparable to PET/CT in the evaluation of colorectal cancer metastases, with a markedly higher accuracy when using combined imaging data than the modalities separately. Further improvement is needed in the imaging of peritoneal carcinomatosis and mucinous tumours.
本研究旨在探讨PET/MRI和PET/CT中不同解剖学与功能成像技术组合在评估转移性结直肠癌病灶方面的诊断性能。
15例结直肠癌患者的影像数据（FDG-PET/CT及后续的FDG-PET/MRI）由两名阅片者在五个阅片环节进行回顾性评估：单独MRI（形态学）、MRI/扩散加权MRI（DWI）、MRI/PET、MRI/DWI/PET；以及PET/CT。总体及基于器官评估每种组合对病灶检测的诊断性能。参考标准由组织学和/或随访影像确定。对黏液性肿瘤进行单独分析。
共评估180个病灶（110个为恶性）（肠道n = 6，肝脏n = 37，淋巴结n = 55，肺n = 4，腹膜n = 74）。基于病灶的总体诊断准确性：MRI为0.46，MRI/DWI为0.47，MRI/PET为0.57，MRI/DWI/PET为0.69，PET/CT为0.66。在基于器官的评估中，MRI/DWI/PET对肝转移灶的准确性最高（0.74），在腹膜病灶（0.55）和淋巴结转移灶（0.84）方面与PET/CT的准确性相当。所有模式下黏液性肿瘤病灶的准确性均有限（MRI/DWI/PET = 0.52）。
包括DWI的PET/MRI在评估结直肠癌转移方面与PET/CT相当，使用联合影像数据时的准确性明显高于单独模式。腹膜癌和黏液性肿瘤的成像仍需进一步改进。
