Lee Dong Ho, Kim Se Hyung, Joo Ijin, Hur Bo Yun, Han Joon Koo
Department of Radiology, Seoul National University Hospital, South Korea; Department of Radiology, Seoul National University College of Medicine, South Korea.
Department of Radiology, Seoul National University Hospital, South Korea; Department of Radiology, Seoul National University College of Medicine, South Korea.
Eur J Radiol. 2016 Jun;85(6):1085-91. doi: 10.1016/j.ejrad.2016.03.015. Epub 2016 Mar 19.
To investigate if 18F-FDG PET/MRI can improve the diagnostic performance of TNM staging and help make an accurate decision for resectability in patients with gastric cancer compared to MDCT.
Forty-two patients with histologically confirmed gastric cancers underwent preoperative MDCT and 18F-FDG PET/MRI. M-staging and resectability was assessed in all patients, and T- and N-staging was evaluated in 30 of 42 patients who underwent curative gastrectomy. Two abdominal radiologists independently assessed their MDCT images and 18F-FDG PET/MRI and determined preoperative TNM staging and resectability of gastric cancers. Diagnostic performance with MDCT and 18F-FDG PET/MRI were compared using McNemar's test and receiver operating characteristic analysis.
Diagnostic accuracies for T and N staging were not significantly different between MDCT and 18F-FDG PET/MRI in both readers. However, 18F-FDG PET/MRI showed significantly improved diagnostic accuracy for M staging in one reader (P=0.008) and marginal improvement in the other reader (P=0.063) compared to MDCT. Regarding the resectability of gastric cancers, diagnostic accuracy (92.9% for both readers) of 18F-FDG PET/MRI was significantly higher than that (76.2% for reader 1 and 64.3% for reader 2) of MDCT in both readers (P<0.05).
18F-FDG PET/MRI may improve diagnostic accuracy for preoperative M staging as well as resectability of gastric cancers compared to MDCT.
探讨与多层螺旋CT（MDCT）相比，18F-氟代脱氧葡萄糖正电子发射断层显像/磁共振成像（18F-FDG PET/MRI）能否提高胃癌TNM分期的诊断效能，并有助于准确判断可切除性。
42例经组织学确诊的胃癌患者术前行MDCT及18F-FDG PET/MRI检查。对所有患者评估M分期及可切除性，对42例中行根治性胃切除术的患者中的30例评估T分期及N分期。两名腹部放射科医生独立评估其MDCT图像及18F-FDG PET/MRI图像，确定胃癌的术前TNM分期及可切除性。采用McNemar检验及受试者操作特征分析比较MDCT与18F-FDG PET/MRI的诊断效能。
两位阅片者中，MDCT与18F-FDG PET/MRI在T分期及N分期的诊断准确性上均无显著差异。然而，与MDCT相比，18F-FDG PET/MRI在一位阅片者中显示M分期的诊断准确性显著提高（P=0.008），在另一位阅片者中显示有边缘性提高（P=0.063）。关于胃癌的可切除性，18F-FDG PET/MRI的诊断准确性（两位阅片者均为92.9%）在两位阅片者中均显著高于MDCT（阅片者1为76.2%，阅片者2为64.3%）（P<0.05）。
与MDCT相比，18F-FDG PET/MRI可能提高胃癌术前M分期的诊断准确性及可切除性。
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