Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland.
Department of Oncology, Örebro University Hospital, Örebro, Sweden.
Acta Oncol. 2020 Jun;59(6):660-665. doi: 10.1080/0284186X.2020.1725243. Epub 2020 Feb 12.
To minimize the radiation exposure of mostly young testicular cancer patients, it is essential to find out whether CT could be replaced by magnetic resonance imaging (MRI) in the staging and follow-up of the patients. In this trial, we examined whether abdominal MRI is as effective as computed tomography (CT) in the detection of retroperitoneal metastases of testicular cancer. This prospective study included 50 patients, 46 cases of retroperitoneal metastases and 4 controls without abdominal metastases (mean age 33, 5 years, range 20-65 years). Imaging of the retroperitoneum was performed using CT and 1.5 T MRI with diffusion weighted imaging (DWI). One experienced radiologist re-analyzed all of the examinations without knowledge of clinical information. All metastatic or suspicious lymph nodes were noted and measured two-dimensionally from axial images. Nodal detection and the size of detected nodes on CT and MRI were compared. There was no significant difference in the detection of retroperitoneal metastasis between CT and MRI. The sensitivity of MRI was 0.98. There was no statistically significant difference in the sizes of lymph nodes found in CT and MRI, and even very small lymph nodes could be detected in MRI as well as in CT. MRI with DWI is as good as CT in detection of retroperitoneal lymph node metastases regardless of lymph node size, and it can be used as part of follow-up of testicular cancer patients instead of ionizing radiation producing imaging methods.
为了使大多数年轻的睾丸癌患者的辐射暴露最小化，必须确定 CT 是否可以在患者的分期和随访中被磁共振成像（MRI）取代。在这项试验中，我们研究了腹部 MRI 是否与计算机断层扫描（CT）一样有效地检测睾丸癌的腹膜后转移。这项前瞻性研究纳入了 50 名患者，其中 46 例存在腹膜后转移，4 例为无腹部转移的对照者（平均年龄 33.5 岁，范围 20-65 岁）。使用 CT 和 1.5T MRI 进行腹膜后成像，包括弥散加权成像（DWI）。一位经验丰富的放射科医生在不了解临床信息的情况下对所有检查进行重新分析。所有转移性或可疑的淋巴结均被记录下来，并从轴位图像上进行二维测量。比较了 CT 和 MRI 对淋巴结的检测和检测到的淋巴结的大小。CT 和 MRI 对腹膜后转移的检测没有显著差异。MRI 的灵敏度为 0.98。CT 和 MRI 中发现的淋巴结大小没有统计学差异，MRI 甚至可以像 CT 一样检测到非常小的淋巴结。MRI 与 CT 一样，在检测腹膜后淋巴结转移方面效果相当，无论淋巴结大小如何，并且可以作为睾丸癌患者随访的一部分，而无需使用产生电离辐射的成像方法。
