Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Korean J Radiol. 2021 May;22(5):714-724. doi: 10.3348/kjr.2020.0689. Epub 2021 Feb 9.
To evaluate the value of F-fluorodeoxyglucose PET/MRI added to contrast-enhanced CT (CECT) in initial staging, assessment of resectability, and postoperative follow-up of biliary tract cancer.
This retrospective study included 100 patients (initial workup [n = 65] and postoperative follow-up [n = 35]) who had undergone PET/MRI and CECT for bile duct or gallbladder lesions between January 2013 and March 2020. Two radiologists independently reviewed the CECT imaging set and CECT plus PET/MRI set to determine the likelihood of malignancy, local and overall resectability, and distant metastasis in the initial workup group, and local recurrence and distant metastasis in the follow-up group. Diagnostic performances of the two imaging sets were compared using clinical-surgical-pathologic findings as standards of reference.
The diagnostic performance of CECT significantly improved after the addition of PET/MRI for liver metastasis (area under the receiver operating characteristic curve [A]: 0.77 vs. 0.91 [ = 0.027] for reviewer 1; 0.76 vs. 0.92 [ = 0.021] for reviewer 2), lymph node metastasis (0.73 vs. 0.92 [ = 0.004]; 0.81 vs. 0.92 [ = 0.023]), and overall resectability (0.79 vs. 0.92 [ = 0.007]; 0.82 vs. 0.94 [ = 0.021]) in the initial workup group. In the follow-up group, the diagnostic performance of CECT plus PET/MRI was significantly higher than that of CECT imaging for local recurrence (0.81 vs. 1.00 [ = 0.029]; 0.82 vs. 0.94 [ = 0.045]).
PET/MRI may add value to CECT in patients with biliary tract cancer both in the initial workup for staging and determination of overall resectability and in follow-up for local recurrence.
评估氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）联合对比增强 CT（CECT）在胆道癌初始分期、可切除性评估和术后随访中的应用价值。
本回顾性研究纳入了 2013 年 1 月至 2020 年 3 月间因胆管或胆囊病变接受 PET/MRI 和 CECT 检查的 100 例患者（初始检查组 [n=65]和术后随访组 [n=35]）。两位放射科医生分别独立分析 CECT 影像集和 CECT 联合 PET/MRI 影像集，以确定初始检查组中恶性肿瘤、局部和整体可切除性以及远处转移的可能性，以及随访组中局部复发和远处转移的可能性。以临床-手术-病理结果为标准参考，比较两种影像学检查方法的诊断性能。
在加入 PET/MRI 后，CECT 对肝转移（观察者 1 的受试者工作特征曲线下面积 [A]：0.77 比 0.91 [=0.027]；观察者 2：0.76 比 0.92 [=0.021]）、淋巴结转移（0.73 比 0.92 [=0.004]；0.81 比 0.92 [=0.023]）和整体可切除性（0.79 比 0.92 [=0.007]；0.82 比 0.94 [=0.021]）的诊断性能显著提高。在随访组中，CECT 联合 PET/MRI 对局部复发的诊断性能明显高于 CECT 成像（0.81 比 1.00 [=0.029]；0.82 比 0.94 [=0.045]）。
在胆道癌患者的初始分期、整体可切除性评估以及局部复发随访中，PET/MRI 可增加 CECT 的价值。
