Wang Danyang, Huo Yanlei, Chen Suyun, Wang Hui, Ding Yingli, Zhu Xiaochun, Ma Chao
Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Nuclear Medicine, Affiliated Third People's Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China.
Onco Targets Ther. 2018 Jun 20;11:3597-3608. doi: 10.2147/OTT.S148189. eCollection 2018.
F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) is the reference standard in staging of F-FDG-avid lymphomas; however, there is no recommended functional imaging modality for indolent lymphomas. Therefore, we aimed to compare the performance of whole-body magnetic resonance imaging (WB-MRI) with that of F-FDG PET/CT for lesion detection and initial staging in patients with aggressive or indolent lymphoma.
We searched the MEDLINE, EMBASE, and CENTRAL databases for studies that compared WB-MRI with F-FDG PET/CT for lymphoma staging or lesion detection. The methodological quality of the studies was assessed using version 2 of the "Quality Assessment of Diagnostic Accuracy Studies" tool. The pooled staging accuracy () of WB-MRI and F-FDG PET/CT for initial staging and for assessing possible heterogeneity () across studies were calculated using commercially available software.
Eight studies comprising 338 patients were included. In terms of staging, the meta-analytic staging accuracies of WB-MRI and F-FDG PET/CT for Hodgkin lymphoma and aggressive non-Hodgkin lymphoma (NHL) were 98% (95% CI, 94%-100%) and 98% (95% CI, 94%-100%), respectively. The pooled staging accuracy of F-FDG PET/CT dropped to 87% (95% CI, 72%-97%) for staging in patients with indolent lymphoma, whereas that of WB-MRI remained 96% (95% CI, 91%-100%). Subgroup analysis indicated an even lower staging accuracy of F-FDG PET/CT for staging of less FDG-avid indolent NHLs (60%; 95% CI, 23%-92%), in contrast to the superior performance of WB-MRI (98%; 95% CI, 88%-100%).
WB-MRI is a promising radiation-free imaging technique that may serve as a viable alternative to F-FDG PET/CT for staging of FDG-avid lymphomas, where F-FDG PET/CT remains the standard of care. Additionally, WB-MRI seems a less histology-dependent functional imaging test than F-FDG PET/CT and may be the imaging test of choice for staging of indolent NHLs with low F-FDG avidity.
氟脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）是F-FDG摄取阳性淋巴瘤分期的参考标准；然而，对于惰性淋巴瘤尚无推荐的功能成像模式。因此，我们旨在比较全身磁共振成像（WB-MRI）与F-FDG PET/CT在侵袭性或惰性淋巴瘤患者病变检测及初始分期方面的表现。
我们检索了MEDLINE、EMBASE和CENTRAL数据库，以查找比较WB-MRI与F-FDG PET/CT用于淋巴瘤分期或病变检测的研究。使用“诊断准确性研究质量评估”工具第2版评估研究的方法学质量。使用商用软件计算WB-MRI和F-FDG PET/CT在初始分期及评估各研究间可能存在的异质性（）方面的合并分期准确性（）。
纳入了八项研究，共338例患者。在分期方面，WB-MRI和F-FDG PET/CT对霍奇金淋巴瘤和侵袭性非霍奇金淋巴瘤（NHL）的荟萃分析分期准确性分别为98%（95%CI，94%-100%）和98%（95%CI，94%-100%）。对于惰性淋巴瘤患者的分期，F-FDG PET/CT的合并分期准确性降至87%（95%CI，72%-97%），而WB-MRI的合并分期准确性仍为96%（95%CI，91%-100%）。亚组分析表明，对于F-FDG摄取较低的惰性NHL分期，F-FDG PET/CT的分期准确性更低（60%；95%CI，23%-92%），与之形成对比的是WB-MRI表现更优（98%；95%CI，88%-100%）。
WB-MRI是一种有前景的无辐射成像技术，对于F-FDG摄取阳性淋巴瘤分期，在F-FDG PET/CT仍是标准治疗手段的情况下，它可能是一种可行的替代方法。此外，WB-MRI似乎是一种比F-FDG PET/CT更少依赖组织学的功能成像检查，可能是F-FDG摄取较低的惰性NHL分期的首选成像检查。
