Malik Vinod, Harmon Mark, Johnston Ciaran, Fagan Andrew J, Claxton Zieta, Ravi Narayanasamy, O'Toole Dermot, Muldoon Cian, Keogan Mary, Reynolds John Vincent, Meaney James F M
Department of Clinical Surgery, St. James's Hospital, Trinity College, Dublin, Ireland.
Dig Surg. 2015;32(5):397-408. doi: 10.1159/000431292. Epub 2015 Aug 26.
Positron emission tomography and computed tomography (PET-CT) is established in the staging of esophageal cancer. In this study, an MRI protocol was designed to emulate the anatomical (T1-weighed (T1W) and T2W imaging) and functional information (diffusion-weighted imaging) provided by PET-CT.
In all, 49 patients with carcinoma of the esophagus underwent PET-CT and whole-body MRI (WBMRI). WBMRI was carried out using dedicated sequences tailored to detect metastatic disease at each area corresponding to the anatomical coverage of PET-CT. Nodal status was determined from histopathology and endoscopic ultrasound biopsy (EUS).
PET-CT and WBMRI identified the primary tumor in 46/49 (94%) and 48/49 (98%) patients, respectively. Nodal analysis in patients undergoing surgery (n = 18) yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 27, 100, 100, 47 and 56% for PET-CT, compared with 30, 100, 100, 53 and 61% for WBMRI. When nodal analysis included both surgical specimens and EUS criteria (n = 39), sensitivity, specificity, PPV, NPV and accuracy were 46, 91, 93, 40 and 59% for PET-CT compared with 59, 92, 94, 50 and 67% for WBMRI. Both imaging modalities identified distant metastases in 2 patients.
WBMRI has similar accuracy to PET-CT in detecting the primary tumor, nodal deposits and for exclusion of systemic metastatic disease.
正电子发射断层扫描与计算机断层扫描（PET-CT）已用于食管癌分期。在本研究中，设计了一种磁共振成像（MRI）方案，以模拟PET-CT提供的解剖学信息（T1加权（T1W）和T2加权成像）和功能信息（扩散加权成像）。
共有49例食管癌患者接受了PET-CT和全身MRI（WBMRI）检查。WBMRI采用专门序列进行，这些序列针对PET-CT解剖覆盖范围内的每个区域检测转移性疾病进行了定制。通过组织病理学和内镜超声活检（EUS）确定淋巴结状态。
PET-CT和WBMRI分别在46/49（94%）和48/49（98%）的患者中发现了原发肿瘤。对接受手术的患者（n = 18）进行淋巴结分析，PET-CT的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为27%、100%、100%、47%和56%，而WBMRI分别为30%、100%、100%、53%和61%。当淋巴结分析同时包括手术标本和EUS标准时（n = 39），PET-CT的敏感性、特异性、PPV、NPV和准确性分别为46%、91%、93%、40%和59%，而WBMRI分别为59%、92%、94%、50%和67%。两种成像方式均在2例患者中发现了远处转移。
在检测原发肿瘤、淋巴结转移灶以及排除全身转移性疾病方面，WBMRI与PET-CT具有相似的准确性。
