Latifoltojar Arash, Duncan Mark K J, Klusmann Maria, Sidhu Harbir, Bainbridge Alan, Neriman Deena, Fraioli Francesco, Lambert Jonathan, Ardeshna Kirit M, Punwani Shonit
Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK.
The Royal Marsden Hospital, Downs road, Sutton, Surrey SM2 5PT, UK.
J Pers Med. 2020 Dec 16;10(4):284. doi: 10.3390/jpm10040284.
To investigate the diagnostic value of different whole-body magnetic resonance imaging (WB-MRI) protocols for staging Hodgkin and diffuse-large B-cell lymphomas (HL and DLBCL), twenty-two patients (M/F 12/10, median age 32, range 22-87, HL/DLBCL 14/8) underwent baseline WB-MRI and F-2-fluoro-2-deoxy-D-glucose (F-FDG) positron emission tomography (PET) fused with computed tomography (CT) scan F-FDG-PET-CT. The 3.0 T WB-MRI was performed using pre-contrast modified Dixon (mDixon), T2-weighted turbo-spin-echo (TSE), diffusion-weighted-imaging (DWI), dynamic-contrast-enhanced (DCE) liver/spleen, contrast-enhanced (CE) lung MRI and CE whole-body mDixon. WB-MRI scans were divided into: (1) "WB-MRI ": whole-body DWI + in-phase mDixon (2) "WB-MRI ": whole-body T2-TSE (3) "WB-MRI ": whole-body CE mDixon + DCE liver/spleen and CE lung mDixon (4) "WB-MRI All ": the entire protocol. Two radiologists evaluated WB-MRIs at random, independently and then in consensus. Two nuclear-medicine-physicians reviewed F-FDG PET-CT in consensus. An enhanced-reference-standard (ERS) was derived using all available baseline and follow-up imaging. The sensitivity and specificity of WB-MRI protocols for nodal and extra-nodal staging was derived against the ERS. Agreement between the WB-MRI protocols and the ERS for overall staging was assessed using kappa statistic. For consensus WB-MRI, the sensitivity and specificity for nodal staging were 75%, 98% for WB-MRI , 76%, 98% for WB-MRI , 83%, 99% for WB-MRI and 87%, 100% for WB-MRI . The sensitivity and specificity for extra-nodal staging were 67% 100% for WB-MRI , 89%, 100% for WB-MRI , 89%, 100% for WB-MRI and 100%, 100% for the WB-MRI . The consensus WB-MRI read had perfect agreement with the ERS for overall staging [kappa = 1.00 (95% CI: 1.00-1.00)]. The best diagnostic performance is achieved combining all available WB-MRI sequences.
为研究不同的全身磁共振成像（WB-MRI）方案对霍奇金淋巴瘤和弥漫性大B细胞淋巴瘤（HL和DLBCL）分期的诊断价值，22例患者（男/女12/10，中位年龄32岁，范围22 - 87岁，HL/DLBCL 14/8）接受了基线WB-MRI检查以及F-2-氟-2-脱氧-D-葡萄糖（F-FDG）正电子发射断层扫描（PET）与计算机断层扫描（CT）融合检查（F-FDG-PET-CT）。采用对比剂前改良狄克逊（mDixon）、T2加权快速自旋回波（TSE）、扩散加权成像（DWI）、动态对比增强（DCE）肝脏/脾脏、对比增强（CE）肺部MRI和CE全身mDixon进行3.0T WB-MRI检查。WB-MRI扫描分为：（1）“WB-MRI ”：全身DWI + 同相位mDixon；（2）“WB-MRI ”：全身T2-TSE；（3）“WB-MRI ”：全身CE mDixon + DCE肝脏/脾脏和CE肺部mDixon；（4）“WB-MRI All”：整个方案。两名放射科医生随机、独立地对WB-MRI进行评估，然后达成共识。两名核医学医师共同审查F-FDG PET-CT。使用所有可用的基线和随访影像得出增强参考标准（ERS）。针对ERS得出WB-MRI方案对淋巴结和结外分期的敏感性和特异性。使用kappa统计量评估WB-MRI方案与ERS在总体分期上的一致性。对于达成共识的WB-MRI，淋巴结分期的敏感性和特异性分别为：WB-MRI 为75%、98%，WB-MRI 为76%、98%，WB-MRI 为83%、99%，WB-MRI 为87%、100%。结外分期的敏感性和特异性分别为：WB-MRI 为67%、100%，WB-MRI 为89%、100%，WB-MRI 为89%、100%，WB-MRI 为100%、100%。达成共识的WB-MRI 解读在总体分期上与ERS具有完美一致性[kappa = 1.00（95%CI：1.00 - 1.00）]。结合所有可用的WB-MRI序列可获得最佳诊断性能。
