Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, USA.
Br J Cancer. 2021 Sep;125(7):975-982. doi: 10.1038/s41416-021-01494-8. Epub 2021 Jul 19.
Oligometastatic colorectal cancer (CRC) is potentially curable and demands individualised strategies.
This single-centre retrospective study investigated if positron emission tomography (PET)/magnetic resonance imaging (MR) had a clinical impact on oligometastatic CRC relative to the standard of care imaging (SCI). Adult patients with oligometastatic CRC on SCI who also underwent PET/MR between 3/2016 and 3/2019 were included. The exclusion criterion was lack of confirmatory standard of reference, either surgical pathology, intraoperative gross confirmation or imaging follow-up. SCI consisted of contrast-enhanced (CE) computed tomography (CT) of the chest/abdomen/pelvis, abdominal/pelvic CE-MR, and/or CE whole-body PET/CT with diagnostic quality (i.e. standard radiation dose) CT. Follow-up was evaluated until 3/2020.
Thirty-one patients constituted the cohort, 16 (52%) male, median patient age was 53 years (interquartile range: 49-65 years). PET/MR and SCI results were divergent in 19% (95% CI 9-37%) of the cases, with PET/MR leading to management changes in all of them. The diagnostic accuracy of PET/MR was 90 ± 5%, versus 71 ± 8% for SCI. In a pairwise analysis, PET/MR outperformed SCI when compared to the reference standard (p = 0.0412).
These findings suggest the potential usefulness of PET/MR in the management of oligometastatic CRC.
寡转移结直肠癌(CRC)具有潜在的可治愈性,需要个体化的治疗策略。
本单中心回顾性研究旨在探讨正电子发射断层扫描(PET)/磁共振成像(MR)相对于标准影像学检查(SCI)对寡转移 CRC 的临床影响。纳入标准为在 SCI 下诊断为寡转移 CRC 的成年患者,且在 2016 年 3 月至 2019 年 3 月期间进行了 PET/MR 检查。排除标准为缺乏确认标准,即无手术病理、术中大体确认或影像学随访。SCI 包括对比增强(CE)胸部/腹部/骨盆计算机断层扫描(CT)、腹部/骨盆 CE-MR 以及/或具有诊断质量(即标准辐射剂量)CT 的全身 CE-PET/CT。随访评估截止至 2020 年 3 月。
31 例患者构成了研究队列,其中 16 例(52%)为男性,中位患者年龄为 53 岁(四分位间距:49-65 岁)。19%(95%CI:9-37%)的病例中 PET/MR 和 SCI 结果不一致,且所有病例的治疗方案均因 PET/MR 结果发生了改变。PET/MR 的诊断准确性为 90%±5%,而 SCI 的诊断准确性为 71%±8%。在两两比较中,与 SCI 相比,PET/MR 与参考标准的一致性更高(p=0.0412)。
这些结果提示 PET/MR 在寡转移 CRC 的管理中具有潜在的应用价值。