Vermersch Mathilde, Emsen Berivan, Monnet Aurélien, Chalaye Julia, Galletto Pregliasco Athena, Baranes Laurence, Rahmouni Alain, Luciani Alain, Itti Emmanuel, Mulé Sébastien
Medical Imaging Department, Henri Mondor University Hospital, Créteil, France.
INSERM Equipes 8 & 18, IMRB, University Paris Est Creteil, Créteil, France.
J Magn Reson Imaging. 2022 Jun;55(6):1683-1693. doi: 10.1002/jmri.27981. Epub 2021 Nov 3.
Whole-body positron emission tomography/magnetic resonance imaging (WB-PET/MRI) is increasingly used in oncology. However, chest staging remains challenging.
To compare the diagnostic performance of a free-breathing 3D-T1-GRE stack-of-stars volume interpolated breath-hold examination (StarVIBE) with that of a 3D-T1-GRE volume interpolated breath-hold examination (VIBE) during WB-PET/MRI for chest staging.
Retrospective, cohort study.
One hundred and twenty-three patients were referred for initial staging of solid cancer, 46 of whom had pulmonary nodules and 14 had pulmonary metastasis.
FIELD STRENGTH/SEQUENCE: Free-breathing 3D-T1-GRE stack-of-stars (StarVIBE) and Cartesian 3D-T1-GRE VIBE at 3.0 T.
Image quality was assessed using a 4-point scale and using the signal-to-noise ratio (SNR) of lung parenchyma and contrast-to-noise ratio (CNR) of pulmonary nodules. Diagnostic performances of both sequences were determined by three independent radiologists for detection of pulmonary nodules, lymph node involvement, and bone metastases using chest CT, pathology, and follow-up as reference standards.
Paired Student's t-test; chi-squared; Fisher's exact test. A P value <0.05 was considered statistically significant.
StarVIBE quality was judged as better in 34% of cases and at least equivalent to VIBE in 89% of cases, with significantly higher quality scores (4 [4-4] vs. 3 [3-4], respectively). SNR and CNR values were significantly higher with StarVIBE (8 ± 1.3 and 9.7 ± 4.6, respectively) than with VIBE (1.8 ± 0.2 and 5.5 ± 3.3, respectively). Compared to VIBE, StarVIBE showed significantly higher sensitivity (73% [95% CI 62-82] vs. 44% [95% CI 33-55], respectively) and specificity (95% [95% CI 88-99] vs. 67% [95% CI 56-77]) for pulmonary nodules detection and significantly higher sensitivity (100% [95% CI 89-100] vs. 67% [95% CI 48-82], respectively) for detection of lymph node involvement. Sensitivities for bone metastases detection were not significantly different (100% [95% CI 88-100] vs. 82% [95% CI 63-94], P = 0.054).
Owing to improved SNR and CNR and spatial resolution, a free-breathing 3D stack-of-stars T1-GRE sequence improves chest staging in comparison with standard 3D-T1-GRE VIBE and may be integrated in WB-PET/MRI acquisitions for initial staging of solid cancer.
3 TECHNICAL EFFICACY: Stage 2.
全身正电子发射断层扫描/磁共振成像（WB-PET/MRI）在肿瘤学中的应用日益广泛。然而，胸部分期仍然具有挑战性。
比较自由呼吸三维T1加权梯度回波序列的星状容积内插屏气检查（StarVIBE）与三维T1加权梯度回波序列的容积内插屏气检查（VIBE）在WB-PET/MRI胸部分期中的诊断性能。
回顾性队列研究。
123例患者因实体癌初诊分期前来就诊，其中46例有肺结节，14例有肺转移。
场强/序列：3.0 T场强下的自由呼吸三维T1加权梯度回波序列的星状容积内插屏气检查（StarVIBE）和笛卡尔三维T1加权梯度回波序列的容积内插屏气检查（VIBE）。
采用4分制评估图像质量，并测量肺实质的信噪比（SNR）和肺结节的对比噪声比（CNR）。由三名独立的放射科医生以胸部CT、病理检查和随访结果作为参考标准，确定两种序列对肺结节、淋巴结受累和骨转移的诊断性能。
配对t检验；卡方检验；Fisher精确检验。P值<0.05被认为具有统计学意义。
34%的病例中StarVIBE的图像质量被判定为更好，89%的病例中其质量至少与VIBE相当，且质量评分显著更高（分别为4[4-4]和3[3-4]）。StarVIBE的SNR和CNR值（分别为8±1.3和9.7±4.6）显著高于VIBE（分别为1.8±0.2和5.5±3.3）。与VIBE相比，StarVIBE在检测肺结节方面显示出显著更高的敏感性（分别为73%[95%CI 62-82]和44%[95%CI 33-55]）和特异性（分别为95%[95%CI 88-99]和67%[95%CI 56-77]），在检测淋巴结受累方面敏感性显著更高（分别为100%[95%CI 89-100]和67%[95%CI 48-82]）。两种序列在检测骨转移方面的敏感性无显著差异（分别为100%[95%CI 88-100]和82%[95%CI 63-94]，P = 0.054）。
由于SNR、CNR和空间分辨率的提高，自由呼吸三维星状T1加权梯度回波序列在胸部分期方面比标准的三维T1加权梯度回波序列VIBE有所改善，可用于整合到WB-PET/MRI采集中，用于实体癌的初诊分期。
3级 技术效能：2级
