Abdominal Imaging Division, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Diagnostic Radiology, Queen's University Kingston Health Sciences Centre, Kingston, ON, Canada.
Abdom Radiol (NY). 2022 Feb;47(2):586-595. doi: 10.1007/s00261-021-03341-z. Epub 2021 Nov 10.
To compare detection rates of NET liver metastases of MRI and Ga-68-DOTATATE PET/CT to provide more clarity when selecting diagnostic imaging tests for NET staging.
In this IRB-approved single-institution retrospective study, all patients with pathology-proven NET who underwent Ga-68-DOTATATE and MRI scans within 8 weeks of each other (3/2017-2/2020) were reviewed. Number of metastases for each patient on diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) MRI, and Ga-68 DOTATATE were recorded by two blinded radiologists, followed by consensus review with two separate blinded readers for MRI and nuclear medicine. Per-lesion and -modality scoring at each lesion location were then performed in consensus. Per-patient linear regression was performed comparing MRI and Ga-68 DOTATATE detection rates for each reader and in consensus, and per-lesion-matched pair difference means were used to compare detection frequency between modalities.
32 patients (mean age 59 years, 59.4% male) and 90 liver metastases were analyzed. Intraclass coefficients (ICC) [95% CI] between the two readers were 0.97 [0.95, 0.99], 0.89 [0.82, 0.94], and 0.98 [0.97, 0.99] for Ga-68 DOTATATE, DWI, and DCE, respectively. Matched per-lesion mean differences were + 0.17 ± 0.07 (p = 0.01) and + 0.22 ± 0.06 (p = < 0.001) for DWI versus Ga-68 DOTATATE and DCE vs Ga-68 DOTATATE, respectively, favoring MRI. Case-based linear regressions estimate that DWI and DCE detect 1.28 [1.07, 1.49] and 1.33 [1.12, 1.54] lesions, respectively, for each one detected on Ga-68 DOTATATE.
MRI detects more hepatic NET metastasis in comparison to Ga-68 DOTATATE. Liver MRI should be performed in concert with Ga-68 DOTATATE in NET staging.
比较 MRI 和 Ga-68-DOTATATE PET/CT 检测神经内分泌肿瘤（NET）肝脏转移的检出率，为选择 NET 分期的诊断影像学检查提供更清晰的依据。
本研究为经机构审查委员会批准的单中心回顾性研究，纳入了在彼此 8 周内（2017 年 3 月至 2020 年 2 月）接受 Ga-68-DOTATATE 和 MRI 扫描且经病理证实为 NET 的所有患者。两名盲法阅片医生分别记录每位患者弥散加权成像（DWI）、动态对比增强（DCE）MRI 和 Ga-68-DOTATATE 上的转移灶数量，随后由两名独立的盲法读者进行 MRI 和核医学的共识审查。然后在共识的基础上对每个病灶位置进行病灶和模态评分。采用患者内线性回归比较每位读者的 MRI 和 Ga-68-DOTATATE 检测率，并在共识的基础上进行病灶匹配对差异的平均值比较，以比较两种模态之间的检测频率。
分析了 32 名患者（平均年龄 59 岁，59.4%为男性）和 90 个肝脏转移灶。两名读者之间的组内相关系数（ICC）[95%CI]分别为 0.97 [0.95，0.99]、0.89 [0.82，0.94]和 0.98 [0.97，0.99]，用于 Ga-68-DOTATATE、DWI 和 DCE。病灶匹配对平均差值分别为+0.17±0.07（p=0.01）和+0.22±0.06（p<0.001），DWI 相对于 Ga-68-DOTATATE 和 DCE 相对于 Ga-68-DOTATATE 均有利于 MRI。基于病例的线性回归估计，DWI 和 DCE 分别检测到 Ga-68-DOTATATE 检测到的每个病变的 1.28[1.07，1.49]和 1.33[1.12，1.54]个病变。
与 Ga-68-DOTATATE 相比，MRI 可检测到更多的肝 NET 转移灶。NET 分期时，应在 Ga-68-DOTATATE 的基础上进行肝脏 MRI 检查。
