From the *Department of Pediatric Radiology, Texas Children's Hospital, Houston; and †Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
Clin Nucl Med. 2017 Aug;42(8):582-588. doi: 10.1097/RLU.0000000000001717.
The aim of this study was to analyze the feasibility and diagnostic performance of F-FDG PET/MR compared with F-FDG PET/CT in a cohort of pediatric histiocytosis patients with regard to image quality, lesion detection, and FDG quantification.
Children with a diagnosis of Langerhans cell histiocytosis or Rosai-Dorfman disease were prospectively recruited. Seventeen PET/CT and PET/MR examinations were performed on 9 patients (mean age, 6.2 years) following a single-injection dual-imaging protocol. The indication was Langerhans cell histiocytosis in 10 examinations and Rosai-Dorfman disease in 7 examinations. The anonymized data were evaluated for image quality and lesion detection. SUV quantification of each lesion was compared between modalities.
All PET/MR examinations had good or excellent image quality and were deemed clinically acceptable. There was substantial agreement of PET image quality among readers of PET/MR images. Per patient, PET/MR and PET/CT had complete concordance in identifying active disease. PET/MRI correctly classified 74 (96%) of 77 foci of disease identified on PET/CT. The per-lesion maximum SUVs were strongly correlated between modalities with a Spearman correlation coefficient of 0.73 (P < 0.001).
The use of PET/MR is clinically feasible in pediatric patients with a histiocytic disease. PET/MR demonstrates comparable image quality and lesion detection to PET/CT while maintaining strongly correlated quantitative performance. Given the significant radiation dose savings, PET/MR represents an appealing alternative to PET/CT in the care of children with histiocytic disorders.
本研究旨在分析 F-FDG PET/MR 相对于 F-FDG PET/CT 在一组儿科组织细胞增生症患者中的可行性和诊断性能，主要涉及图像质量、病灶检出和 FDG 定量。
前瞻性招募诊断为朗格汉斯细胞组织细胞增生症或罗道尔夫-多夫曼病的儿童。9 例患儿（平均年龄 6.2 岁）按单注射双成像方案进行了 17 次 PET/CT 和 PET/MR 检查。10 次检查的适应证为朗格汉斯细胞组织细胞增生症，7 次检查的适应证为罗道尔夫-多夫曼病。对匿名数据进行了图像质量和病灶检出评估。比较了两种模式下每个病灶的 SUV 定量。
所有 PET/MR 检查均具有良好或优秀的图像质量，被认为是临床可接受的。PET/MR 图像的读者对 PET 图像质量的评价具有高度一致性。每例患者，PET/MR 和 PET/CT 在识别活动性疾病方面均完全一致。PET/MRI 正确分类了 77 个病灶中的 74 个（96%），这些病灶在 PET/CT 上均有发现。病灶最大 SUV 的定量值在两种模式之间具有很强的相关性，Spearman 相关系数为 0.73（P<0.001）。
在患有组织细胞疾病的儿科患者中，使用 PET/MR 是可行的。PET/MR 在提供与 PET/CT 相当的图像质量和病灶检出的同时，还保持了定量性能的强相关性。鉴于显著减少了辐射剂量，在患有组织细胞疾病的儿童的治疗中，PET/MR 是一种很有吸引力的替代方法，优于 PET/CT。
