脑肿瘤研究中 PET/MRI 衰减校正方法的验证。
Validation of PET/MRI attenuation correction methodology in the study of brain tumours.
机构信息
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
出版信息
BMC Med Imaging. 2020 Nov 25;20(1):126. doi: 10.1186/s12880-020-00526-8.
BACKGROUND
This study aims to compare proton density weighted magnetic resonance imaging (MRI) zero echo time (ZTE) and head atlas attenuation correction (AC) to the reference standard computed tomography (CT) based AC for C-methionine positron emission tomography (PET)/MRI.
METHODS
A retrospective cohort of 14 patients with suspected or confirmed brain tumour and C-Methionine PET/MRI was included in the study. For each scan, three AC maps were generated: ZTE-AC, atlas-AC and reference standard CT-AC. Maximum and mean standardised uptake values (SUV) were measured in the hotspot, mirror region and frontal cortex. In postoperative patients (n = 8), SUV values were additionally obtained adjacent to the metal implant and mirror region. Standardised uptake ratios (SUR) hotspot/mirror, hotspot/cortex and metal/mirror were then calculated and analysed with Bland-Altman, Pearson correlation and intraclass correlation reliability in the overall group and subgroups.
RESULTS
ZTE-AC demonstrated narrower SD and 95% CI (Bland-Altman) than atlas-AC in the hotspot analysis for all groups (ZTE overall ≤ 2.84, - 1.41 to 1.70; metal ≤ 1.67, - 3.00 to 2.20; non-metal ≤ 3.04, - 0.96 to 3.38; Atlas overall ≤ 4.56, - 1.05 to 3.83; metal ≤ 3.87, - 3.81 to 4.64; non-metal ≤ 4.90, - 1.68 to 5.86). The mean bias for both ZTE-AC and atlas-AC was ≤ 2.4% compared to CT-AC. In the metal region analysis, ZTE-AC demonstrated a narrower mean bias range-closer to zero-and narrower SD and 95% CI (ZTE 0.21-0.48, ≤ 2.50, - 1.70 to 2.57; Atlas 0.56-1.54, ≤ 4.01, - 1.81 to 4.89). The mean bias for both ZTE-AC and atlas-AC was within 1.6%. A perfect correlation (Pearson correlation) was found for both ZTE-AC and atlas-AC compared to CT-AC in the hotspot and metal analysis (ZTE ρ 1.00, p < 0.0001; atlas ρ 1.00, p < 0.0001). An almost perfect intraclass correlation coefficient for absolute agreement was found between Atlas-, ZTE and CT maps for maxSUR and meanSUR values in all the analyses (ICC > 0.99).
CONCLUSIONS
Both ZTE and atlas-AC showed a good performance against CT-AC in patients with brain tumour.
背景
本研究旨在比较质子密度加权磁共振成像（MRI）零回波时间（ZTE）和头部图谱衰减校正（AC）与参考标准 CT 基于 AC 对 C-蛋氨酸正电子发射断层扫描（PET）/MRI 的性能。
方法
回顾性纳入 14 例疑似或确诊脑肿瘤并接受 C-蛋氨酸 PET/MRI 的患者。对每个扫描，生成三种 AC 图：ZTE-AC、图谱-AC 和参考标准 CT-AC。在热点、镜像区和额叶皮质中测量最大和平均标准化摄取值（SUV）。在术后患者（n=8）中，还在金属植入物和镜像区附近获得 SUV 值。然后，在总体组和亚组中，使用 Bland-Altman、Pearson 相关性和组内相关可靠性分析计算和分析热点/镜像、热点/皮质和金属/镜像的标准化摄取比值（SUR）。
结果
在所有组的热点分析中，ZTE-AC 的 SD 和 95%CI（Bland-Altman）均小于图谱-AC（ZTE 总体≤2.84，-1.41 至 1.70；金属≤1.67，-3.00 至 2.20；非金属≤3.04，-0.96 至 3.38；图谱总体≤4.56，-1.05 至 3.83；金属≤3.87，-3.81 至 4.64；非金属≤4.90，-1.68 至 5.86）。与 CT-AC 相比，ZTE-AC 和图谱-AC 的平均偏差均≤2.4%。在金属区域分析中，ZTE-AC 显示出更窄的平均偏差范围-接近零-以及更窄的 SD 和 95%CI（ZTE 0.21-0.48，≤2.50，-1.70 至 2.57；图谱 0.56-1.54，≤4.01，-1.81 至 4.89）。与 CT-AC 相比，ZTE-AC 和图谱-AC 的平均偏差均在 1.6%以内。在热点和金属分析中，ZTE-AC 和图谱-AC 与 CT-AC 之间均存在完美的相关性（Pearson 相关性）（ZTE ρ1.00，p<0.0001；图谱 ρ1.00，p<0.0001）。在所有分析中，图谱、ZTE 和 CT 图之间的最大和平均 SUR 值的绝对一致性的几乎完美的组内相关系数（ICC>0.99）。
结论
在脑肿瘤患者中，ZTE 和图谱-AC 与 CT-AC 相比均表现良好。
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