[18F]氟代脱氧葡萄糖正电子发射断层扫描/磁共振成像检测肝转移灶的准确性
Accuracy of [18F]FDG PET/MRI for the Detection of Liver Metastases.
作者信息
Beiderwellen Karsten, Geraldo Llanos, Ruhlmann Verena, Heusch Philipp, Gomez Benedikt, Nensa Felix, Umutlu Lale, Lauenstein Thomas C
机构信息
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Department of Nuclear Medicine, University Hospital Santa Creu i Sant Pau, Barcelona, Spain.
出版信息
PLoS One. 2015 Sep 3;10(9):e0137285. doi: 10.1371/journal.pone.0137285. eCollection 2015.
BACKGROUND
The aim of this study was to compare the diagnostic accuracy of [18F]FDG-PET/MRI with PET/CT for the detection of liver metastases.
METHODS
32 patients with solid malignancies underwent [18F]FDG-PET/CT and subsequent PET/MRI of the liver. Two readers assessed both datasets regarding lesion characterization (benign, indeterminate, malignant), conspicuity and diagnostic confidence. An imaging follow-up (mean interval: 185±92 days) and/-or histopathological specimen served as standards of reference. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for both modalities. Accuracy was determined by calculating the area under the receiver operating characteristic (ROC) curve. Values of conspicuity and diagnostic confidence were compared using Wilcoxon-signed-rank test.
RESULTS
The standard of reference revealed 113 liver lesions in 26 patients (malignant: n = 45; benign: n = 68). For PET/MRI a higher accuracy (PET/CT: 82.4%; PET/MRI: 96.1%; p<0.001) as well as sensitivity (67.8% vs. 92.2%, p<0.01) and NPV (82.0% vs. 95.1%, p<0.05) were observed. PET/MRI offered higher lesion conspicuity (PET/CT: 2.0±1.1 [median: 2; range 0-3]; PET/MRI: 2.8±0.5 [median: 3; range 0-3]; p<0.001) and diagnostic confidence (PET/CT: 2.0±0.8 [median: 2; range: 1-3]; PET/MRI 2.6±0.6 [median: 3; range: 1-3]; p<0.001). Furthermore, PET/MRI enabled the detection of additional PET-negative metastases (reader 1: 10; reader 2: 12).
CONCLUSIONS
PET/MRI offers higher diagnostic accuracy compared to PET/CT for the detection of liver metastases.
背景
本研究旨在比较[18F]FDG-PET/MRI与PET/CT检测肝转移瘤的诊断准确性。
方法
32例实体恶性肿瘤患者接受了[18F]FDG-PET/CT及随后的肝脏PET/MRI检查。两名阅片者对两个数据集的病变特征（良性、不确定、恶性）、清晰度及诊断信心进行评估。影像学随访（平均间隔：185±92天）和/或组织病理学标本作为参考标准。计算两种检查方法的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。通过计算受试者工作特征（ROC）曲线下面积来确定准确性。使用Wilcoxon符号秩检验比较清晰度和诊断信心值。
结果
参考标准显示26例患者有113个肝脏病变（恶性：n = 45；良性：n = 68）。PET/MRI具有更高的准确性（PET/CT：82.4%；PET/MRI：96.1%；p<0.001）、敏感性（67.8%对92.2%，p<0.01）和NPV（82.0%对95.1%，p<0.05）。PET/MRI的病变清晰度更高（PET/CT：2.0±1.1[中位数：2；范围0-3]；PET/MRI：2.8±0.5[中位数：3；范围0-3]；p<0.001），诊断信心也更高（PET/CT：2.0±0.8[中位数：2；范围：1-3]；PET/MRI 2.6±0.6[中位数：3；范围：1-3]；p<0.001）。此外，PET/MRI能够检测出额外的PET阴性转移瘤（阅片者1：10个；阅片者2：12个）。
结论
在检测肝转移瘤方面，PET/MRI比PET/CT具有更高的诊断准确性。
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