Zhang Jiahui, Chen Yongye, Zhang Yanyan, Zhang Enlong, Yu Hon J, Yuan Huishu, Zhang Yang, Su Min-Ying, Lang Ning
Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
Department of Nuclear Medicine, Peking University Third Hospital, Beijing, People's Republic of China.
Eur Spine J. 2020 May;29(5):1061-1070. doi: 10.1007/s00586-019-06213-9. Epub 2019 Nov 21.
To investigate the correlation of parameters measured by dynamic-contrast-enhanced MRI (DCE-MRI) and F-FDG PET/CT in spinal tumors, and their role in differential diagnosis.
A total of 49 patients with pathologically confirmed spinal tumors, including 38 malignant, six benign and five borderline tumors, were analyzed. The MRI and PET/CT were done within 3 days, before biopsy. On MRI, the ROI was manually placed on area showing the strongest enhancement to measure pharmacokinetic parameters K and k. On PET, the maximum standardized uptake value SUV was measured. The parameters in different histological groups were compared. ROC was performed to differentiate between the two largest subtypes, metastases and plasmacytomas. Spearman rank correlation was performed to compare DCE-MRI and PET/CT parameters.
The K, k and SUV were not statistically different among malignant, benign and borderline groups (P = 0.95, 0.50, 0.11). There was no significant correlation between K and SUV (r = - 0.20, P = 0.18), or between k and SUV (r = - 0.16, P = 0.28). The k was significantly higher in plasmacytoma than in metastasis (0.78 ± 0.17 vs. 0.61 ± 0.18, P = 0.02); in contrast, the SUV was significantly lower in plasmacytoma than in metastasis (5.58 ± 2.16 vs. 9.37 ± 4.26, P = 0.03). In differential diagnosis, the AUC of k and SUV was 0.79 and 0.78, respectively.
The vascular parameters measured by DCE-MRI and glucose metabolism measured by PET/CT from the most aggressive tumor area did not show a significant correlation. The results suggest they provide complementary information reflecting different aspects of the tumor, which may aid in diagnosis of spinal lesions. These slides can be retrieved under Electronic Supplementary Material.
探讨动态对比增强磁共振成像（DCE-MRI）与F-FDG PET/CT测量的参数在脊柱肿瘤中的相关性及其在鉴别诊断中的作用。
分析49例经病理证实的脊柱肿瘤患者，其中恶性肿瘤38例，良性肿瘤6例，交界性肿瘤5例。在活检前3天内进行MRI和PET/CT检查。在MRI上，将感兴趣区（ROI）手动放置在强化最明显的区域，测量药代动力学参数K和k。在PET上，测量最大标准化摄取值SUV。比较不同组织学组的参数。采用ROC曲线对最大的两个亚型，即转移瘤和浆细胞瘤进行鉴别诊断。采用Spearman等级相关性分析比较DCE-MRI和PET/CT参数。
恶性、良性和交界性组之间的K、k和SUV无统计学差异（P = 0.95、0.50、0.11）。K与SUV之间无显著相关性（r = -0.20，P = 0.18），k与SUV之间也无显著相关性（r = -0.16，P = 0.28）。浆细胞瘤的k显著高于转移瘤（0.78±0.17 vs. 0.61±0.18，P = 0.02）；相反，浆细胞瘤的SUV显著低于转移瘤（5.58±2.16 vs. 9.37±4.26，P = 0.03）。在鉴别诊断中，k和SUV的AUC分别为0.79和0.78。
DCE-MRI测量的血管参数与PET/CT从最具侵袭性肿瘤区域测量的葡萄糖代谢无显著相关性。结果表明它们提供了反映肿瘤不同方面的互补信息，可能有助于脊柱病变的诊断。这些幻灯片可在电子补充材料中获取。
