Department of Radiology, University College London Hospital, London, United Kingdom.
Department of Radiology, Great Ormond Street Hospital, London, United Kingdom.
J Nucl Med. 2021 Nov;62(11):1524-1530. doi: 10.2967/jnumed.120.260059. Epub 2021 Feb 19.
Treatment regimens for pediatric Hodgkin lymphoma (HL) depend on accurate staging and treatment response assessment, based on accurate disease distribution and metabolic activity depiction. With the aim of radiation dose reduction, we compared the diagnostic performance of F-FDG PET/MRI with a F-FDG PET/CT reference standard for staging and response assessment. Twenty-four patients (mean age, 15.4 y; range, 8-19.5 y) with histologically proven HL were prospectively and consecutively recruited in 2015 and 2016, undergoing both F-FDG PET/CT and F-FDG PET/MRI at initial staging ( = 24) and at response assessment ( = 21). The diagnostic accuracy of F-FDG PET/MRI for both nodal and extranodal disease was compared with that of F-FDG PET/CT, which was considered the reference standard. Discrepancies were retrospectively classified as perceptual or technical errors, and F-FDG PET/MRI and F-FDG PET/CT were corrected by removing perceptual error. Agreement with Ann Arbor staging and Deauville grading was also assessed. For nodal and extranodal sites combined, corrected staging F-FDG PET/MRI sensitivity was 100% (95% CI, 96.7%-100%) and specificity was 99.5% (95% CI, 98.3%-99.9%). Corrected response-assessment F-FDG PET/MRI sensitivity was 83.3% (95% CI, 36.5%-99.1%) and specificity was 100% (95% CI, 99.2%-100%). Modified Ann Arbor staging agreement between F-FDG PET/CT and F-FDG PET/MRI was perfect (κ = 1.0, = 0.000). Deauville grading agreement between F-FDG PET/MRI and F-FDG PET/CT was excellent (κ = 0.835, = 0.000). F-FDG PET/MRI is a promising alternative to F-FDG PET/CT for staging and response assessment in children with HL.
儿童霍奇金淋巴瘤（HL）的治疗方案取决于准确的分期和治疗反应评估，这需要基于准确的疾病分布和代谢活性描述。为了降低辐射剂量，我们比较了 F-FDG PET/MRI 与 F-FDG PET/CT 参考标准在分期和反应评估中的诊断性能。2015 年至 2016 年，我们前瞻性连续招募了 24 例经组织学证实的 HL 患儿（平均年龄 15.4 岁；范围 8-19.5 岁），分别在初始分期（=24）和反应评估时（=21）进行 F-FDG PET/CT 和 F-FDG PET/MRI。比较了 F-FDG PET/MRI 对结内和结外疾病的诊断准确性，将 F-FDG PET/CT 视为参考标准。通过去除感知错误，回顾性地将差异分类为感知或技术错误，并纠正 F-FDG PET/MRI 和 F-FDG PET/CT。还评估了与安阿伯分期和德沃尔夫分级的一致性。对于结内和结外部位的联合，校正后的分期 F-FDG PET/MRI 的敏感性为 100%（95%CI，96.7%-100%），特异性为 99.5%（95%CI，98.3%-99.9%）。校正后的反应评估 F-FDG PET/MRI 的敏感性为 83.3%（95%CI，36.5%-99.1%），特异性为 100%（95%CI，99.2%-100%）。F-FDG PET/CT 和 F-FDG PET/MRI 之间的改良安阿伯分期一致性为完美（κ=1.0，=0.000）。F-FDG PET/MRI 和 F-FDG PET/CT 之间的德沃尔夫分级一致性为优秀（κ=0.835，=0.000）。F-FDG PET/MRI 是一种有前途的替代 F-FDG PET/CT 的方法，可用于儿童 HL 的分期和反应评估。
