头颈部鳞状细胞癌远处转移及远处第二原发癌的检测：[F]FDG PET/MRI与[F]FDG PET/CT的比较
Detection of distant metastases and distant second primary cancers in head and neck squamous cell carcinoma: comparison of [F]FDG PET/MRI and [F]FDG PET/CT.
作者信息
Katirtzidou Eirini, Rager Olivier, Varoquaux Arthur Damien, Poncet Antoine, Lenoir Vincent, Dulguerov Nicolas, Platon Alexandra, Garibotto Valentina, Zaidi Habib, Becker Minerva
机构信息
Division of Radiology, Diagnostic Department, Geneva University Hospitals, University of Geneva, Rue Gabrielle Perret Gentil 4, CH-1205, Geneva, Switzerland.
Division of Nuclear Medicine, Diagnostic Department, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
出版信息
Insights Imaging. 2022 Jul 28;13(1):121. doi: 10.1186/s13244-022-01261-0.
PURPOSE
This prospective study aimed to compare the diagnostic performance of []FDG PET/MRI and PET/CT for the detection of distant metastases and distant second primary cancers in patients with head and neck squamous cell carcinoma (HNSCC).
METHODS
A total of 103 [F]FDG PET/MRI examinations immediately followed by PET/CT were obtained in 82 consecutive patients for staging of primary HNSCC (n = 38), suspected loco-regional recurrence/follow-up (n = 41) or unknown primary HNSCC (n = 3). Histology and follow-up > 2 years formed the standard of reference. Blinded readers evaluated the anonymized PET/MRI and PET/CT examinations separately using a 5-point Likert score. Statistical analysis included: receiver operating characteristic (ROC) analysis, jackknife alternative free-response ROC (JAFROC) and region-of-interest (ROI)-based ROC to account for data clustering and sensitivity/specificity/accuracy comparisons for a score ≥ 3.
RESULTS
Distant metastases and distant second primary cancers were present in 23/103 (22%) examinations in 16/82 (19.5%) patients, and they were more common in the post-treatment group (11/41, 27%) than in the primary HNSCC group (3/38, 8%), p = 0.039. The area under the curve (AUC) per patient/examination/lesion was 0.947 [0.927-1]/0.965 [0.917-1]/0.957 [0.928-0.987] for PET/MRI and 0.975 [0.950-1]/0.968 [0.920-1]/0.944 [0.910-0.979] for PET/CT, respectively (p > 0.05). The diagnostic performance of PET/MRI and PET/CT was similar according to JAFROC (p = 0.919) and ROI-based ROC analysis (p = 0.574). Sensitivity/specificity/accuracy for PET/MRI and PET/CT for a score ≥ 3 was 94%/88%/89% and 94%/91%/91% per patient, 96%/90%/91% and 96%/93%/93% per examination and 95%/85%/90% and 90%/86%/88% per lesion, respectively, p > 0.05.
CONCLUSIONS
In HNSCC patients, PET/MRI and PET/CT had a high and similar diagnostic performance for detecting distant metastases and distant second primary cancers.
目的
本前瞻性研究旨在比较[F]DG PET/MRI和PET/CT在检测头颈部鳞状细胞癌（HNSCC）患者远处转移和远处第二原发性癌症方面的诊断性能。
方法
对82例连续患者进行了总共103次[F]FDG PET/MRI检查，随后立即进行PET/CT检查，以对原发性HNSCC（n = 38）、疑似局部区域复发/随访（n = 41）或原发性不明HNSCC（n = 3）进行分期。组织学检查和超过2年的随访构成参考标准。不知情的阅片者分别使用5分李克特量表对匿名的PET/MRI和PET/CT检查进行评估。统计分析包括：受试者操作特征（ROC）分析、留一法替代自由响应ROC（JAFROC）和基于感兴趣区域（ROI）的ROC，以考虑数据聚类以及对评分≥3的敏感性/特异性/准确性比较。
结果
16/82（19.5%）例患者的23/103（22%）次检查中存在远处转移和远处第二原发性癌症，且在治疗后组（11/41，27%）中比原发性HNSCC组（3/38，8%）更常见，p = 0.039。PET/MRI每患者/检查/病灶的曲线下面积（AUC）分别为0.947[0.927 - 1]/0.965[0.917 - 1]/0.957[0.928 - 0.987]，PET/CT分别为0.975[0.950 - 1]/0.968[0.920 - 1]/0.944[0.910 - 0.979]（p > 0.05）。根据JAFROC（p = 0.919）和基于ROI的ROC分析（p = 0.574），PET/MRI和PET/CT的诊断性能相似。PET/MRI和PET/CT评分≥3时每患者的敏感性/特异性/准确性分别为94%/88%/89%和94%/91%/91%，每次检查分别为96%/90%/91%和96%/93%/93%，每个病灶分别为95%/85%/90%和90%/86%/88%，p > 0.05。
结论
在HNSCC患者中，PET/MRI和PET/CT在检测远处转移和远处第二原发性癌症方面具有较高且相似的诊断性能。
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