[F]FDG PET/MRI 联合胸部 HRCT 用于早期癌症检测：3020 例无症状受检者的回顾性研究。
[F]FDG PET/MRI combined with chest HRCT in early cancer detection: a retrospective study of 3020 asymptomatic subjects.
机构信息
Shanghai Universal Medical Imaging Diagnostic Center, Shanghai, China.
Department of Nuclear Medicine and PET-CT Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, Hangzhou, China.
出版信息
Eur J Nucl Med Mol Imaging. 2023 Oct;50(12):3723-3734. doi: 10.1007/s00259-023-06273-6. Epub 2023 Jul 4.
PURPOSE
PET/MRI has become an important medical imaging approach in clinical practice. In this study, we retrospectively investigated the detectability of fluorine-18 (F)-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ([F]FDG PET/MRI) combined with chest computerized tomography (CT) for early cancer in a large cohort of asymptomatic subjects.
METHODS
This study included a total of 3020 asymptomatic subjects who underwent whole-body [F]FDG PET/MRI and chest HRCT examinations. All subjects received a 2-4-year follow-up for cancer development. Cancer detection rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the [F]FDG PET/MRI with or without chest HRCT were calculated and analyzed.
RESULTS
Sixty-one subjects were pathologically diagnosed with cancers, among which 59 were correctly detected by [F]FDG PET/MRI combined with chest HRCT. Of the 59 patients (32 with lung cancer, 9 with breast cancer, 6 with thyroid cancer, 5 with colon cancer, 3 with renal cancer, 1 with prostate cancer, 1 with gastric cancer, 1 with endometrial cancer, and 1 with lymphoma), 54 (91.5%) were at stage 0 or stage I (according to the 8th edition of the tumor-node-metastasis [TNM] staging system), 33 (55.9%) were detected by PET/MRI alone (27 with non-lung cancers and 6 with lung cancer). Cancer detection rate, sensitivity, specificity, PPV, and NPV for PET/MRI combined with chest CT were 2.0%, 96.7%, 99.6%, 83.1%, and 99.9%, respectively. For PET/MRI alone, the metrics were 1.1%, 54.1%, 99.6%, 73.3%, and 99.1%, respectively, and for PET/MRI in non-lung cancers, the metrics were 0.9%, 93.1%, 99.6%, 69.2%, and 99.9%, respectively.
CONCLUSIONS
[F]FDG PET/MRI holds great promise for the early detection of non-lung cancers, while it seems insufficient for detecting early-stage lung cancers. Chest HRCT can be complementary to whole-body PET/MRI for early cancer detection.
TRIAL REGISTRATION
ChiCTR2200060041. Registered 16 May 2022. Public site: https://www.chictr.org.cn/index.html.
目的
正电子发射断层扫描/磁共振成像（PET/MRI）已成为临床实践中的一种重要医学成像方法。在这项研究中，我们回顾性地研究了氟-18（F）-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（[F]FDG PET/MRI）联合胸部计算机断层扫描（CT）在一大群无症状受试者中早期癌症的检测能力。
方法
本研究共纳入 3020 名无症状受试者，均行全身[F]FDG PET/MRI 和胸部高分辨率 CT（HRCT）检查。所有受试者均接受 2-4 年的癌症发展随访。计算并分析了[F]FDG PET/MRI 联合或不联合胸部 HRCT 的癌症检出率、灵敏度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。
结果
61 名受试者经病理诊断为癌症，其中 59 名经[F]FDG PET/MRI 联合胸部 HRCT 正确检出。59 名患者（32 例肺癌、9 例乳腺癌、6 例甲状腺癌、5 例结肠癌、3 例肾癌、1 例前列腺癌、1 例胃癌、1 例子宫内膜癌和 1 例淋巴瘤）中，54 例（91.5%）为 0 期或 I 期（根据第 8 版肿瘤-淋巴结-转移分期系统），33 例（55.9%）仅通过 PET/MRI 检出（27 例非肺癌和 6 例肺癌）。PET/MRI 联合胸部 CT 的癌症检出率、灵敏度、特异度、PPV 和 NPV 分别为 2.0%、96.7%、99.6%、83.1%和 99.9%。PET/MRI 单独检查时的指标分别为 1.1%、54.1%、99.6%、73.3%和 99.1%，非肺癌患者的指标分别为 0.9%、93.1%、99.6%、69.2%和 99.9%。
结论
[F]FDG PET/MRI 对非肺癌的早期检测具有很大的潜力，而对早期肺癌的检测似乎还不够。胸部 HRCT 可作为全身 PET/MRI 早期癌症检测的补充。
试验注册
ChiCTR2200060041。注册于 2022 年 5 月 16 日。公共网站：https://www.chictr.org.cn/index.html。
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