氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描及磁共振成像在检测T1-T2期头颈部鳞状细胞癌中的诊断效能
Diagnostic performance of fluorodesoxyglucose positron emission/computed tomography and magnetic resonance imaging in detecting T1-T2 head and neck squamous cell carcinoma.
作者信息
Chaput Anne, Robin Philippe, Podeur Fabien, Ollivier Morgan, Keromnes Nathalie, Tissot Valentin, Nonent Michel, Salaün Pierre-Yves, Rousset Jean, Abgral Ronan
机构信息
Department of Nuclear Medicine, University Hospital of Brest, Brest, France.
Thrombosis Study Group in Western Brittany, Research's Federative Institute 148, European University of Brittany, Brest, France.
出版信息
Laryngoscope. 2018 Feb;128(2):378-385. doi: 10.1002/lary.26729. Epub 2017 Jun 10.
OBJECTIVES/HYPOTHESIS: The aim of this study was to assess and compare the diagnostic accuracy of fluorodesoxyglucose positron emission/computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI) to detect T1-T2 head and neck squamous cell carcinoma (HNSCC).
STUDY DESIGN
Prospective case series.
METHODS
Thirty-five consecutive patients with histologically proven T1-T2 HNSCC were prospectively included. All patients underwent pretherapeutic FDG-PET/CT and MRI. Two nuclear medicine physicians and 2 radiologists blindly reviewed all FDG-PET/CT and MRI, respectively. A five-point qualitative scale was used to estimate tumor detection ability. Sensitivity of each modality was compared together using a McNemar test. Interobserver variability was assessed by kappa index (κ) of Cohen statistics. Maximal standardized uptake value (SUV ), metabolic tumor volume (MTV) in FDG-PET/CT, and gadolinium enhancement (%GE) in MRI of each tumor were recorded and compared with T stage using a Mann-Whitney test. Tumor-to-normal tissue ratios in FDG-PET/CT and MRI (TNR and TNR ) were calculated and compared together using a Student t test.
RESULTS
Among the 35 primary tumors, 29 were detected by FDG-PET/CT and 22 by MRI. MRI detected none of the six lesions incorrectly identified by FDG-PET/CT. FDG-PET/CT correctly identified seven of the 13 MRI false-negative results. Sensitivity of FDG-PET/CT to detect T1-T2 HNSCC was significantly higher than MRI (83% vs. 63%, P = .015). T stage was significantly correlated with MTV (P = .002) unlike with SUV (P = .06) and %GE (P = .70). TNR was significantly higher than TNR (3.5 ± 3.2 vs. 1.2 ± 0.3, P < .0001).
CONCLUSIONS
Our study showed a higher diagnostic accuracy of FDG-PET/CT than MRI to detect T1-T2 HNSCC with a good interobserver agreement.
LEVEL OF EVIDENCE
- Laryngoscope, 128:378-385, 2018.
目的/假设：本研究旨在评估和比较氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）和磁共振成像（MRI）检测T1-T2期头颈部鳞状细胞癌（HNSCC）的诊断准确性。
研究设计
前瞻性病例系列研究。
方法
前瞻性纳入35例经组织学证实为T1-T2期HNSCC的连续患者。所有患者均接受治疗前FDG-PET/CT和MRI检查。两名核医学医师和两名放射科医师分别对所有FDG-PET/CT和MRI图像进行盲法评估。采用五点定性量表评估肿瘤检测能力。使用McNemar检验比较每种检查方法的敏感性。通过Cohen统计的kappa指数（κ）评估观察者间的变异性。记录每个肿瘤在FDG-PET/CT中的最大标准化摄取值（SUV）、代谢肿瘤体积（MTV）以及在MRI中的钆增强率（%GE），并使用Mann-Whitney检验与T分期进行比较。计算FDG-PET/CT和MRI中的肿瘤与正常组织比值（TNR和TNR），并使用Student t检验进行比较。
结果
在35个原发性肿瘤中，FDG-PET/CT检测出29个，MRI检测出22个。MRI未检测出FDG-PET/CT错误识别的6个病变中的任何一个。FDG-PET/CT正确识别了13个MRI假阴性结果中的7个。FDG-PET/CT检测T1-T2期HNSCC的敏感性显著高于MRI（83%对63%，P = 0.015）。T分期与MTV显著相关（P = 0.002），与SUV（P = 0.06）和%GE（P = 0.70）无关。TNR显著高于TNR（3.5±3.2对1.2±0.3，P < 0.0001）。
结论
我们的研究表明，FDG-PET/CT检测T1-T2期HNSCC的诊断准确性高于MRI，且观察者间一致性良好。
证据水平
4。《喉镜》，2018年第128卷：378 - 38
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