Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
MAgNetic Resonance Technology for Response Adapted Radiotherapy (MANTRA), Odense University Hospital, Odense, Denmark.
Eur J Nucl Med Mol Imaging. 2019 Sep;46(10):2138-2151. doi: 10.1007/s00259-019-04402-8. Epub 2019 Jul 2.
PET/MRI was introduced for clinical use in 2011 and is now an established modality for the imaging of brain and certain pelvic cancers, whereas clinical use for the imaging of other forms of cancer is not yet widespread. We therefore systematically investigated what has been published on the use of PET/MRI compared to PET/CT in the imaging of cancers outside the brain, focusing on clinical areas of application related to diagnosis, staging and restaging.
A systematic search of PubMed/MEDLINE, Embase and the Cochrane Library was performed. Studies evaluating the diagnostic performance of simultaneous PET/MRI in cancer patients were chosen.
A total of 3,138 publications were identified and 116 published during the period 2012-2018 were included and were grouped according to the major cancer forms: 13 head and neck (HNC), 9 breast (BC), 21 prostate (PC), 14 gynaecological, 13 gastrointestinal (GIC), and 46 various cancers. Data from studies comparing PET/MRI and PET/CT for staging/restaging suggested the superiority of F-FDG PET/MRI for the detection of tumour extension and retropharyngeal lymph node metastases in nasopharyngeal cancer, and for the detection of liver metastases and possibly bone marrow metastases in high-risk BC. FDG PET/MRI tended to be inferior for the detection of lung metastases in HNC and BC. Ga-PSMA-11 PET/MRI was superior to PET/CT for the detection of local PC recurrence. FDG PET/MRI was superior to FDG PET/CT for the detection of local tumour invasion in cervical cancer and had higher accuracy for the detection of liver metastases in colorectal cancer.
The scoping review methodology resulted in the identification of a huge number of records, of which less than 5% were suitable for inclusion and only a limited number allowed conclusions on the advantages/disadvantages of PET/MRI compared to PET/CT in the oncological setting. There was evidence to support the use of FDG PET/MRI in staging of nasopharyngeal cancer and high-risk BC. Preliminary data indicate the superiority of PET/MRI for the detection of local recurrence in PC, local tumour invasion in cervical cancer, and liver metastases in colorectal cancer. These conclusions are based on small datasets and need to be further explored.
正电子发射断层扫描/磁共振成像（PET/MRI）于 2011 年开始应用于临床，目前已成为脑和某些盆腔癌症成像的成熟手段，而其在其他类型癌症成像中的临床应用尚未广泛普及。因此，我们系统地研究了与诊断、分期和再分期相关的临床应用领域中，与脑外癌症成像相关的、已发表的关于 PET/MRI 与正电子发射断层扫描/计算机断层扫描（PET/CT）比较的文献。
对 PubMed/MEDLINE、Embase 和 Cochrane 图书馆进行了系统检索。选择了评估癌症患者同时进行 PET/MRI 诊断性能的研究。
共确定了 3138 篇文献，纳入了 2012 年至 2018 年期间发表的 116 篇文献，并根据主要癌症类型进行了分组：13 篇头颈部（HNC）、9 篇乳腺（BC）、21 篇前列腺（PC）、14 篇妇科、13 篇胃肠道（GIC）和 46 篇各种癌症。比较 PET/MRI 和 PET/CT 用于分期/再分期的研究数据表明，在鼻咽癌中，对于肿瘤延伸和咽后淋巴结转移的检测，以及对于高危 BC 中肝转移和可能骨髓转移的检测，18F-FDG PET/MRI 具有优势。在 HNC 和 BC 中，18F-FDG PET/MRI 对检测肺转移的效果较差。镓-PSMA-11 PET/MRI 对检测局部 PC 复发具有优势。18F-FDG PET/MRI 对检测宫颈癌局部肿瘤侵袭具有优势，在检测结直肠癌肝转移方面具有更高的准确性。
通过范围界定综述方法，确定了大量记录，其中只有不到 5%适合纳入，只有少数记录能够得出关于在肿瘤学环境中 PET/MRI 相对于 PET/CT 的优势/劣势的结论。有证据支持在鼻咽癌和高危 BC 的分期中使用 18F-FDG PET/MRI。初步数据表明，在 PC 的局部复发、宫颈癌的局部肿瘤侵袭和结直肠癌的肝转移的检测中，PET/MRI 具有优势。这些结论基于小数据集，需要进一步探索。
