Usuda Katsuo, Ishikawa Masahito, Iwai Shun, Yamagata Aika, Iijima Yoshihito, Motono Nozomu, Matoba Munetaka, Doai Mariko, Hirata Keiya, Uramoto Hidetaka
Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa 920-0293, Japan.
Shimada Hospital, Fukui 910-0855, Japan.
Cancers (Basel). 2021 Oct 14;13(20):5166. doi: 10.3390/cancers13205166.
The purpose of this retrospective study was to compare the diagnostic efficacy of FDG-PET/CT and MRI in discriminating malignant from benign pulmonary nodules and masses (PNMs). There were 278 lung cancers and 50 benign PNMs that were examined by FDG-PET/CT and MRI. The T2 contrast ratio (T2 CR) was designated as the ratio of T2 signal intensity of PNM divided by T2 signal intensity of the rhomboid muscle. The optimal cut-off values (OCVs) for differential diagnosis were 3.605 for maximum standardized uptake value (SUVmax), 1.459 × 10 mm/s for apparent diffusion coefficient (ADC), and 2.46 for T2 CR. Areas under the receiver operating characteristics curves were 67.5% for SUVmax, 74.3% for ADC, and 72.4% for T2 CR, respectively. The sensitivity (0.658) of SUVmax was significantly lower than that (0.838) of ADC ( < 0.001) and that (0.871) of T2 CR ( < 0.001). The specificity (0.620) of SUVmax was that the same as (0.640) ADC and (0.640) of T2 CR. The accuracy (0.652) of SUVmax was significantly lower than that (0.808) of ADC ( < 0.001) and that (0.835) of T2 CR ( < 0.001). The sensitivity and accuracy of DWI and T2WI in MRI were significantly higher than those of FDG-PET/CT. Ultimately, MRI can replace FDG PET/CT for differential diagnosis of PNMs saving healthcare systems money while not sacrificing the quality of care.
这项回顾性研究的目的是比较氟代脱氧葡萄糖正电子发射断层显像/X线计算机体层成像（FDG-PET/CT）和磁共振成像（MRI）在鉴别肺内良恶性结节及肿块（PNM）方面的诊断效能。共有278例肺癌和50例良性PNM接受了FDG-PET/CT及MRI检查。T2对比率（T2 CR）定义为PNM的T2信号强度与菱形肌T2信号强度之比。鉴别诊断的最佳截断值（OCV）分别为：最大标准化摄取值（SUVmax）为3.605，表观扩散系数（ADC）为1.459×10 mm/s，T2 CR为2.46。受试者工作特征曲线下面积分别为：SUVmax为67.5%，ADC为74.3%，T2 CR为72.4%。SUVmax的敏感度（0.658）显著低于ADC的敏感度（0.838）（P<0.001）及T2 CR的敏感度（0.871）（P<0.001）。SUVmax的特异度（0.620）与ADC的特异度（0.640）及T2 CR的特异度（0.640）相同。SUVmax的准确度（0.652）显著低于ADC的准确度（0.808）（P<0.001）及T2 CR的准确度（0.835）（P<0.001）。MRI中扩散加权成像（DWI）及T2加权成像（T2WI）的敏感度和准确度显著高于FDG-PET/CT。最终，MRI可替代FDG-PET/CT用于PNM的鉴别诊断，在不牺牲医疗质量的同时节省医疗系统成本。
