采用全身扩散加权成像和 T2 加权 MRI 评估惰性非侵袭性淋巴瘤：30 例患者前瞻性研究结果。
Assessment of naive indolent lymphoma using whole-body diffusion-weighted imaging and T2-weighted MRI: results of a prospective study in 30 patients.
机构信息
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
出版信息
Cancer Imaging. 2021 Jan 7;21(1):5. doi: 10.1186/s40644-020-00371-6.
BACKGROUND
We prospectively evaluated the diagnostic utility of whole-body diffusion-weighted imaging with background body signal suppression and T2-weighted short-tau inversion recovery MRI (WB-DWIBS/STIR) for the pretherapeutic staging of indolent lymphoma in 30 patients.
METHODS
This prospective study included 30 treatment-naive patients with indolent lymphomas who underwent WB-DWIBS/STIR and conventional imaging workup plus biopsy. The pretherapeutic staging agreement, sensitivity, and specificity of WB-DWIBS/STIR were investigated with reference to the multimodality and multidisciplinary consensus review for nodal and extranodal lesions excluding bone marrow.
RESULTS
In the pretherapeutic staging, WB-DWIBS/STIR showed very good agreement (κ = 0.96; confidence interval [CI], 0.88-1.00), high sensitivity (93.4-95.1%), and high specificity (99.0-99.4%) for the whole-body regions. These results were similar to those of F-FDG-PET/CT, except for the sensitivity for extranodal lesions. For extranodal lesions, WB-DWIBS/STIR showed higher sensitivity compared to F-FDG-PET/CT for the whole-body regions (94.9-96.8% vs. 79.6-86.3%, P = 0.058).
CONCLUSION
WB-DWIBS/STIR is an effective modality for the pretherapeutic staging of indolent lymphoma, and it has benefits when evaluating extranodal lesions, compared with F-FDG-PET/CT.
背景
我们前瞻性地评估了全身弥散加权成像（背景抑制）与 T2 短反转恢复（STIR）联合应用（WB-DWIBS/STIR）在 30 例惰性淋巴瘤患者治疗前分期中的诊断价值。
方法
本前瞻性研究纳入 30 例初治惰性淋巴瘤患者，所有患者均接受 WB-DWIBS/STIR 检查、常规影像学检查及活检。采用多模态、多学科综合评估（包括骨髓），以评估 WB-DWIBS/STIR 在淋巴结和结外病变分期中的准确性、敏感度和特异度。
结果
在治疗前分期中，WB-DWIBS/STIR 与多模态和多学科综合评估的一致性非常好（κ=0.96；置信区间 [CI]，0.88-1.00），对全身淋巴结和结外病变的敏感度分别为 93.4%-95.1%和 99.0%-99.4%，与 F-FDG-PET/CT 相似，但结外病变的敏感度除外。与 F-FDG-PET/CT 相比，WB-DWIBS/STIR 对全身淋巴结和结外病变的敏感度更高（94.9%-96.8%比 79.6%-86.3%，P=0.058）。
结论
与 F-FDG-PET/CT 相比，WB-DWIBS/STIR 是一种有效的惰性淋巴瘤治疗前分期方法，尤其在评估结外病变方面具有优势。
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