Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany.
Eur J Nucl Med Mol Imaging. 2017 Oct;44(11):1823-1831. doi: 10.1007/s00259-017-3736-y. Epub 2017 May 31.
To assess and compare the diagnostic accuracy of PET/MRI and MRI alone for the detection of local recurrences of soft tissue sarcomas (STS) after initial surgical resection of the primary tumors.
A total of 41 patients with clinically suspected tumor relapse of STS underwent an F-FDG-PET/MRI examination for assessment of local recurrence. Two experienced physicians interpreted the MRI data and subsequently the PET/MRI datasets in two separate reading sessions and were instructed to identify potential local tumor recurrences. Additionally, the diagnostic confidence in each reading for the identification of malignant lesions was determined. A McNemar test was applied to test for differences of both ratings and a Wilcoxon signed-rank test was used to identify differences of the confidence levels. Histopathological verification and follow-up imaging were applied for standard of reference.
Tumor relapse was present in 27/41 patients. Calculated sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for the detection of local tumor recurrence was 82%, 86%, 92%, 71% and 83% for MRI, and 96%, 79%, 90%, 92% and 90% for PET/MRI (p > 0.05). Furthermore, PET/MRI showed significantly higher confidence levels (p < 0.05) for the determination of malignant lesions.
Our results endorse F-FDG PET/MRI to be an excellent imaging method in the evaluation of recurrent STS after surgical excision, yielding superior tumor detection when compared to MRI alone.
评估和比较 PET/MRI 与 MRI 单独用于检测原发性肿瘤切除后软组织肉瘤（STS）局部复发的诊断准确性。
共 41 例临床怀疑 STS 肿瘤复发的患者接受 F-FDG-PET/MRI 检查，以评估局部复发情况。两位有经验的医生分别在两次独立的阅读会议中解读 MRI 数据和随后的 PET/MRI 数据集，并被指示识别潜在的局部肿瘤复发。此外，还确定了每位医生在识别恶性病变时的诊断信心。采用 McNemar 检验比较两种评分的差异，采用 Wilcoxon 符号秩检验比较置信水平的差异。组织病理学验证和随访影像学用于参考标准。
27/41 例患者存在肿瘤复发。计算 MRI 检测局部肿瘤复发的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 82%、86%、92%、71%和 83%，PET/MRI 分别为 96%、79%、90%、92%和 90%（p>0.05）。此外，PET/MRI 对恶性病变的判断具有更高的置信水平（p<0.05）。
我们的结果支持 F-FDG PET/MRI 是评估外科切除后复发性 STS 的一种极好的成像方法，与单独 MRI 相比，在肿瘤检测方面具有更高的优势。
