正电子发射断层扫描/磁共振成像（PET/MRI）弥散加权成像（DWI）用于头颈部鳞状细胞癌（HNSCC）患者的淋巴结评估。
Diffusion-Weighted Imaging (DWI) derived from PET/MRI for lymph node assessment in patients with Head and Neck Squamous Cell Carcinoma (HNSCC).
机构信息
Doctoral School of Health Sciences, University of Pécs, P.O. Box: 7621, Vorosmarty 4, Pecs, Hungary.
Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, Kaposvár, Hungary.
出版信息
Cancer Imaging. 2020 Aug 8;20(1):56. doi: 10.1186/s40644-020-00334-x.
BACKGROUND
To determine the usefulness of Diffusion Weighted Imaging (DWI) derived from PET/MRI in discriminating normal from metastatic lymph nodes and the correlation between the metastatic lymph nodes with the grade and the localization of the primary tumor.
METHODS
Retrospective study of 90 lymph nodes from 90 subjects; 65 patients who had proven histopathological metastatic lymph nodes from (HNSCC) who had undergone F- PET/MRI for clinical staging and assessment and twenty-five lymph nodes were chosen from 25 healthy subjects. Apparent Diffusion Coefficient (ADC) map was generated from DWI with b values (0 and 800 s/mm). ADC values of the metastatic lymph nodes were calculated and compared to the normal lymph nodes ADC values, ROC was used to determine the best cut-off values to differentiate between the two group. Metastatic lymph nodes ADC mean values were compared to primary tumor grade and localization.
RESULTS
ADCmean value of the metastatic lymph nodes in the overall sample (0.899 ± 0.9810 mm/sec) was significantly lower than the normal lymph nodes' ADCmean value (1.267 ± 0.8810 mm/sec); (P = 0.001). The area under the curve (AUC) was 98.3%, sensitivity and specificity were 92.3 and 98.6%, respectively, when using a threshold value of (1.138 ± 0.7510 mm/sec) to differentiate between both groups. Significant difference was found between metastatic lymph nodes (short-axis diameter < 10 mm), ADCmean (0.898 ± 0.7210 mm/sec), and the benign lymph nodes ADCmean, (P = 0.001). No significant difference was found between ADCmean of the metastatic lymph nodes < 10 mm and the metastatic lymph nodes > 10 mm, ADCmean (0.899 ± 0.89*10 mm/sec), (P = 0.967). No significant differences were found between metastatic lymph nodes ADCmean values and different primary tumor grades or different primary tumor localization, (P > 0.05).
CONCLUSION
DWI-ADC is an effective and efficient imaging technique in differentiating between normal and malignant lymph nodes, and might be helpful to discriminate sub-centimeters lymph nodes.
TRIAL REGISTRATION
The trial is registered in clinical trials under ID: NCT04360993 , registration date: 17/04/2020.
背景
确定正电子发射断层扫描（PET）/磁共振成像（MRI）衍生的弥散加权成像（DWI）在区分正常淋巴结和转移性淋巴结以及转移性淋巴结与原发肿瘤分级和定位之间的相关性的有用性。
方法
回顾性研究 90 例患者的 90 个淋巴结；65 例经组织病理学证实为（HNSCC）的转移性淋巴结患者接受 F- PET/MRI 进行临床分期和评估，25 个淋巴结取自 25 例健康受试者。从 DWI 生成表观弥散系数（ADC）图，b 值（0 和 800s/mm）。计算转移性淋巴结的 ADC 值，并与正常淋巴结 ADC 值进行比较，ROC 用于确定区分两组的最佳截断值。比较转移性淋巴结 ADC 平均值与原发肿瘤分级和定位。
结果
总体样本中转移性淋巴结的 ADCmean 值（0.899±0.9810mm/sec）明显低于正常淋巴结的 ADCmean 值（1.267±0.8810mm/sec）；（P=0.001）。曲线下面积（AUC）为 98.3%，当使用阈值（1.138±0.7510mm/sec）来区分两组时，灵敏度和特异性分别为 92.3%和 98.6%。转移性淋巴结（短轴直径<10mm）、ADCmean（0.898±0.7210mm/sec）与良性淋巴结 ADCmean 之间存在显著差异，（P=0.001）。直径<10mm 的转移性淋巴结和直径>10mm 的转移性淋巴结的 ADCmean 之间无显著差异，ADCmean（0.899±0.89*10mm/sec），（P=0.967）。转移性淋巴结 ADCmean 值与不同的原发肿瘤分级或不同的原发肿瘤定位之间无显著差异，（P>0.05）。
结论
DWI-ADC 是一种区分正常和恶性淋巴结的有效且高效的成像技术，可能有助于区分亚厘米淋巴结。
试验注册
该试验在临床试验中注册，ID：NCT04360993，注册日期：2020 年 4 月 17 日。
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