Berzaczy Dominik, Giraudo Chiara, Haug Alexander R, Raderer Markus, Senn Daniela, Karanikas Georgios, Weber Michael, Mayerhoefer Marius E
From the Divisions of *General and Pediatric Radiology and †Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, and ‡Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Clin Nucl Med. 2017 Sep;42(9):669-674. doi: 10.1097/RLU.0000000000001753.
The aim of this study was to assess the diagnostic performance of simultaneous whole-body Ga-DOTANOC PET/MRI compared with Ga-DOTANOC PET/CT for detection of distant metastatic disease in patients with well-differentiated neuroendocrine tumors (NETs).
Patients with histologically proven, well-differentiated NET (G1 or G2) were included in this prospective, institutional review board-approved study. Patients underwent Ga-DOTANOC PET/CT and subsequent Ga-DOTANOC PET/MRI after a single tracer injection on the same day for staging or restaging purposes. Images were evaluated for the presence of NET lesions by 2 rater teams, each consisting of a nuclear medicine physician and a radiologist, in an observer-blinded fashion. Overall agreement, accuracy, sensitivity, and specificity, relative to a composite reference standard (consensus review including follow-up data), were calculated.
Between July 2014 and June 2016, 28 patients were enrolled. Overall agreement and accuracy between the 2 rater teams were 91.7% (95% confidence interval [CI], 87.5%-95.9%) and 97% (95% CI, 94.4%-99.6%) for PET/MRI and 92.3% (95% CI, 88.3%-96.3%) and 94.6% (95% CI, 91.2%-98.1%) for PET/CT, respectively (P = 1.00).Overall, PET/MRI reached 89.8% sensitivity (95% CI, 77.8%-96.6%) and 100% specificity (95% CI, 97%-100%); PET/CT showed 81.6% sensitivity (95% CI, 68%-91.2%) and 100% specificity (95% CI, 97%-100%) for the detection of metastatic disease in NETs.
Whole-body Ga-DOTANOC PET/MRI appears to be comparable to Ga-DOTANOC PET/CT for lesion detection in patients with well-differentiated NETs.
本研究旨在评估同时进行的全身镓-多他曲肽正电子发射断层扫描/磁共振成像（Ga-DOTANOC PET/MRI）与Ga-DOTANOC正电子发射断层扫描/计算机断层扫描（PET/CT）在检测高分化神经内分泌肿瘤（NETs）患者远处转移疾病方面的诊断性能。
组织学证实为高分化NET（G1或G2）的患者纳入这项前瞻性、经机构审查委员会批准的研究。患者在同一天单次注射示踪剂后接受Ga-DOTANOC PET/CT及随后的Ga-DOTANOC PET/MRI检查，以进行分期或再分期。由2个评估团队以观察者盲法评估NET病变的存在情况，每个团队由一名核医学医师和一名放射科医生组成。计算相对于综合参考标准（包括随访数据的共识审查）的总体一致性、准确性、敏感性和特异性。
2014年7月至2016年6月期间，共纳入28例患者。对于PET/MRI，2个评估团队之间的总体一致性和准确性分别为91.7%（95%置信区间[CI]，87.5%-95.9%）和97%（95%CI，94.4%-99.6%）；对于PET/CT，分别为92.3%（95%CI，88.3%-96.3%）和94.6%（95%CI，91.2%-98.1%）（P = 1.00）。总体而言，PET/MRI的敏感性达到89.8%（95%CI，77.8%-96.6%），特异性达到100%（95%CI，97%-100%）；PET/CT在检测NETs转移疾病方面的敏感性为81.6%（95%CI，68%-91.2%），特异性为100%（95%CI，97%-100%）。
对于高分化NETs患者，全身Ga-DOTANOC PET/MRI在病变检测方面似乎与Ga-DOTANOC PET/CT相当。
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