Zhou Nina, Meng Xiangxi, Zhang Yan, Yu Boqi, Yuan Jianmin, Yu Jiangyuan, Zhu Hua, Yang Zhi
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China.
Central Research Institute, United Imaging Healthcare Group, Shanghai, China.
Front Oncol. 2021 Aug 30;11:717687. doi: 10.3389/fonc.2021.717687. eCollection 2021.
The aim of this study was to evaluate the value of a delayed positron emission tomography/magnetic resonance (PET/MR) scan relative to a single positron emission tomography/computed tomography (PET/CT) scan for liver metastasis detection.
In this study, 70 patients with solid malignancies and suspicious liver lesions undergoing 2-deoxy-2-[F]fluoro--glucose [(F)FDG] PET/CT and subsequent delayed liver PET/MR scans were analyzed. The histopathological analysis and/or imaging follow-up were performed as the standard of reference. Lesion maximum standardized uptake value (SUVmax), diameter, and tumor to nontumor ratio (T/N) were measured. Lesion detection sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both examinations.
(1) The standard of reference revealed 208 liver lesions in 70 patients (metastasis in 56 patients with 196 lesions; benign in 14 patients with 12 lesions). Compared with PET/CT, PET/MR had higher accuracy (98.6% 78.6%), sensitivity (98.2% 76.8%), and specificity (100.0% 85.7%) (2). The therapeutic strategies of 29 patients (41.4%) needed reconsideration after the additional PET/MR, including new metastases detected (13/70), new affected lobes identified (14/70), and false-positive corrected (2/70) (3). PET/MR detected significantly more metastases than PET/CT did, especially with small lesions. The SUVmax of the same lesion correlated well between the two acquisitions, while the delayed PET showed a higher T/N ratio.
In liver metastasis detection, the diagnostic value of the delayed PET/MR is validated to be superior to that of PET/CT, which may aid the clinical decision-making.
本研究旨在评估延迟正电子发射断层扫描/磁共振成像（PET/MR）相对于单次正电子发射断层扫描/计算机断层扫描（PET/CT）在检测肝转移方面的价值。
本研究分析了70例患有实体恶性肿瘤且肝脏病变可疑的患者，这些患者接受了2-脱氧-2-[F]氟-D-葡萄糖[（F）FDG]PET/CT及随后的肝脏延迟PET/MR扫描。以组织病理学分析和/或影像学随访作为参考标准。测量病变的最大标准化摄取值（SUVmax）、直径和肿瘤与非肿瘤比值（T/N）。计算两种检查的病变检测灵敏度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。
（1）参考标准显示70例患者中有208个肝脏病变（56例患者有196个转移灶；14例患者有12个良性病变）。与PET/CT相比，PET/MR具有更高的准确性（98.6%对78.6%）、灵敏度（98.2%对76.8%）和特异度（100.0%对85.7%）。（2）在进行额外的PET/MR检查后，29例患者（41.4%）的治疗策略需要重新考虑，包括检测到新的转移灶（13/70）、识别出新的受累肝叶（14/70）以及纠正假阳性结果（2/70）。（3）PET/MR检测到的转移灶明显多于PET/CT，尤其是对于小病变。两次检查中同一病变的SUVmax相关性良好，而延迟PET显示出更高的T/N比值。
在肝转移检测中，延迟PET/MR的诊断价值经证实优于PET/CT，这可能有助于临床决策。
