Tahtabasi Mehmet, Erturk Sukru Mehmet, Basak Muzaffer
Department of Radiology, University of Health Sciences Turkey, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
Department of Radiology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):12-17. doi: 10.14744/SEMB.2020.80270. eCollection 2021.
To compare the efficacy of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) and magnetic resonance imaging (MRI) in the detection of liver metastases originating from the gastrointestinal system (GIS) and the pancreaticobiliary (PB) system.
This retrospective study included 42 patients with primary GIS (stomach or colorectal) or PB system malignancies that metastasized to the liver, histopathologically confirmed diagnoses, and MRI and 18F-FDG PET/CT images. The MRI and 18F-FDG PET/CT images were analyzed. Student's t-test was used to compare the two modalities in terms of determining the number of metastases, and Cohen's kappa test was conducted to determine the agreement between the modalities.
Twenty-eight (66.7%) of the patients included in this study were male, and the mean age was 60.67±9.4 years. Colon (n=25; 59.5%) and pancreatic (n=7; 16.6%) adenocarcinomas were the most common primary tumors that had metastasized to the liver. MRI detected more metastases in 12 (28.5%) patients, less in seven (16.6%), and an equal number of metastases in 23 (54.7%). No statistically significant difference was observed between the number of metastases detected by MRI and 18F-FDG PET/CT (7.55±7.96 and 6.36±7.28, respectively; p=0.11). There was a moderate agreement between the two modalities (kappa value=0.423). Most of the metastases detected on MRI but not seen on 18F-FDG PET/CT (n=10, 23.8%) were lesions smaller than 10 mm. For the eight (19%) patients with lymph node metastases, the number of metastatic lymph nodes detected by MRI and 18F-FDG PET/CT was similar (12 and 14, respectively, p>0.05).
MRI can detect small lesions at an early stage, and 18F-FDG PET/CT shows the metabolic activity of lesions; therefore, the combined use of the two modalities can potentially offer a beneficial outcome for patients.
比较18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET/CT）与磁共振成像（MRI）在检测源自胃肠道系统（GIS）和胰胆管（PB）系统的肝转移瘤方面的疗效。
这项回顾性研究纳入了42例原发性GIS（胃或结直肠）或PB系统恶性肿瘤发生肝转移、经组织病理学确诊且有MRI和18F-FDG PET/CT图像的患者。对MRI和18F-FDG PET/CT图像进行分析。采用学生t检验比较两种检查方式在确定转移瘤数量方面的差异，并采用Cohen卡方检验确定两种检查方式之间的一致性。
本研究纳入的患者中28例（66.7%）为男性，平均年龄为60.67±9.4岁。结肠癌（n = 25；59.5%）和胰腺癌（n = 7；16.6%）是转移至肝脏的最常见原发性肿瘤。MRI在12例（28.5%）患者中检测到更多转移瘤，在7例（16.6%）患者中检测到更少转移瘤，在23例（54.7%）患者中检测到的转移瘤数量相同。MRI和18F-FDG PET/CT检测到的转移瘤数量之间未观察到统计学显著差异（分别为7.55±7.96和 6.36±7.28；p = 0.11）。两种检查方式之间存在中度一致性（kappa值 = 0.423）。MRI检测到但18F-FDG PET/CT未发现的大多数转移瘤（n = 10，23.8%）为小于10 mm的病灶。对于8例（19%）有淋巴结转移的患者，MRI和18F-FDG PET/CT检测到的转移淋巴结数量相似（分别为12个和14个，p>0.05）。
MRI能够早期检测到小病灶，18F-FDG PET/CT显示病灶的代谢活性；因此，联合使用这两种检查方式可能会给患者带来有益的结果。
