Peng W B, Sun X, Zhou M, Wei X S, Wu X Z, Ruan W W, Shi H Z, Lan X L, Zhou Q
Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology/Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
Zhonghua Yi Xue Za Zhi. 2021 Aug 10;101(30):2363-2369. doi: 10.3760/cma.j.cn112137-20210516-01142.
To investigate the diagnostic value of PET/MRI for malignant pleural effusion (MPE), and compare its diagnostic difference with PET/CT. The data of 57 patients with suspected MPE admitted into Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from October 2017 to January 2020 was analyzed. A total of 53 patients were included in the prospective study, and the whole body PET/CT and thoracic PET/MRI were performed on them respectively. Two physicians used a blind method to evaluate the morphological features of PET/CT and PET/MRI images, delineate the region of interest (ROI), obtain the maximum standard uptake value (SUVmax) of the ROI in the PET/CT and PET/MRI images. The target-to-background ratio (TBR) of the lesion was calculated. The diffusion-weighted imaging (DWI) characteristics of the pleura in PET/MRI images were analyzed. Taking pathological diagnosis as the gold standard, the diagnostic effect of PET/CT and PET/MRI on MPE were evaluated. The 53 patients who were finally included were (62.8±1.7) years old, consisting of 31 males. Pathological results showed that 41 cases were MPE and 12 cases were benign pleural effusion (BPE). There were no statistical differences in age, gender and smoking history between the two groups (>0.05). Bland-Altman analysis showed that the SUVmax of pleural lesions by PET/MRI was higher than that by PET/CT (6.4±0.6 vs 5.3±0.5, <0.001). The TBR of PET/MRI was higher than that of PET/CT (2.2±0.2 vs 1.8±0.2, <0.001). The sensitivity, specificity, and accuracy of PET/MRI in the diagnosis of MPE by combining imaging features such as SUVmax and DWI of pleural lesions were 75.6%, 100%, and 81.1%, respectively. The sensitivity, specificity, and accuracy of PET/CT combined with SUVmax and imaging features of pleural lesions in the diagnosis of MPE were 85.4%, 83.3%, and 77.4%, respectively. There was no statistically significant difference between PET/MRI and PET/CT in the area under the curve (AUC) for diagnosing MPE (0.934 vs 0.873, >0.05). PET/MRI and PET/CT have the equivalent diagnostic efficiency for MPE. However, PET/MRI shows higher SUVmax and TBR for pleural lesions, and has specific pleural DWI imaging characteristics, which is worthy of further clinical research.
探讨正电子发射断层显像/磁共振成像（PET/MRI）对恶性胸腔积液（MPE）的诊断价值，并比较其与正电子发射断层显像/计算机断层扫描（PET/CT）的诊断差异。分析了2017年10月至2020年1月在华中科技大学同济医学院附属协和医院收治的57例疑似MPE患者的数据。前瞻性研究共纳入53例患者，分别对其进行全身PET/CT和胸部PET/MRI检查。两名医师采用盲法评估PET/CT和PET/MRI图像的形态学特征，勾画感兴趣区（ROI），获取PET/CT和PET/MRI图像中ROI的最大标准摄取值（SUVmax）。计算病变的靶本比（TBR）。分析PET/MRI图像中胸膜的扩散加权成像（DWI）特征。以病理诊断为金标准，评估PET/CT和PET/MRI对MPE的诊断效果。最终纳入的53例患者年龄为（62.8±1.7）岁，其中男性31例。病理结果显示，41例为MPE，12例为良性胸腔积液（BPE）。两组患者在年龄、性别和吸烟史方面差异无统计学意义（>0.05）。Bland-Altman分析显示，PET/MRI显示的胸膜病变SUVmax高于PET/CT（6.4±0.6 vs 5.3±0.5，<0.001）。PET/MRI的TBR高于PET/CT（2.2±0.2 vs 1.8±0.2，<0.001）。PET/MRI结合胸膜病变的SUVmax和DWI等影像特征诊断MPE的灵敏度、特异度和准确度分别为75.6%、1
