[镓]镓-多柔比星PET/CT与PET/MRI的个体内定性和定量比较。
Intra-individual qualitative and quantitative comparison of [Ga]Ga-DOTATATE PET/CT and PET/MRI.
作者信息
Lens Géraldine, Ahmadi Bidakhvidi Niloefar, Vandecaveye Vincent, Grauwels Steven, Laenen Annouschka, Deckers Wies, Peeters Ronald, Dresen Raphaëla C, Dekervel Jeroen, Verslype Chris, Nackaerts Kristiaan, Clement Paul M, Van Cutsem Eric, Koole Michel, Goffin Karolien, Van Laere Koen, Deroose Christophe M
机构信息
Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium.
Nuclear Medicine, University Hospitals Leuven, Leuven, BelgiumNuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
出版信息
Ther Adv Med Oncol. 2023 Oct 24;15:17588359231189133. doi: 10.1177/17588359231189133. eCollection 2023.
BACKGROUND
Somatostatin receptor (SSTR) positron emission tomography (PET) is a cornerstone of neuroendocrine tumor (NET) management. Hybrid PET/magnetic resonance imaging (MRI) is now available for NET-imaging, next to PET/computed tomography (CT).
OBJECTIVES
To determine whether CT or MRI is the best hybrid partner for [Ga]Ga-DOTATATE PET.
DESIGN
Monocentric, prospective study.
METHODS
Patients received a same-day [Ga]Ga-DOTATATE PET/CT and subsequent PET/MRI, for suspicion of NET, (re)staging or peptide receptor radionuclide therapy-selection. The union (PET) of malignant lesions detected on PET and PET was the reference standard. Concordance of detection of malignant lesions in an organ was measured between PET and CT and PET and MRI. Seven bins were used to categorize the number of malignant lesions, containing following ordinal variables: 0, 1, 2-5, 6-10, 11-20, >20 countable and diffuse/uncountable. The difference in number of malignant lesions was obtained as the difference in bin level ('Δbin') between PET and CT and PET and MRI with a Δbin closer to zero implying a higher concordance rate.
RESULTS
Twenty-nine patients were included. Primary tumors included 17 gastroenteropancreatic-NETs, 1 colon neuroendocrine carcinoma, 7 lung-NETs and 2 meningiomas. Patient level concordance with PET was 96% for MRI and 67% for CT ( = 0.039). Organ level concordance with PET was 74% for MRI and 40% for CT ( < 0.0001). In bone, there was a higher concordance rate for MRI compared to CT, 92% and 33%, respectively ( = 0.016). Overall, a mean Δbin of 0.5 ± 1.1 for PET/MRI and 1.4 ± 1.2 for PET/CT ( < 0.0001) was noted. In liver, a mean Δbin of 0.0 ± 1.1 for PET/MRI and 1.7 ± 1.2 for PET/CT was observed ( = 0.0078). In bone, a mean Δbin closer to zero was observed for PET/MRI compared to PET/CT, 0.6 ± 1.4 and 2.0 ± 1.5, respectively ( = 0.0098).
CONCLUSIONS
Compared to SSTR PET/CT, SSTR PET/MRI had a higher patient and organ level concordance for malignant tumoral involvement and number of malignant lesions, with a clear added value in bone and liver specifically.
背景
生长抑素受体（SSTR）正电子发射断层扫描（PET）是神经内分泌肿瘤（NET）管理的基石。除了PET/计算机断层扫描（CT）外，PET/磁共振成像（MRI）现在也可用于NET成像。
目的
确定CT还是MRI是[镓]镓-奥曲肽PET的最佳联合检查手段。
设计
单中心前瞻性研究。
方法
因怀疑患有NET、进行（再）分期或选择肽受体放射性核素治疗，患者在同一天接受[镓]镓-奥曲肽PET/CT及随后的PET/MRI检查。PET和PET上检测到的恶性病变的并集（PET）为参考标准。测量PET与CT以及PET与MRI之间在一个器官中检测到的恶性病变的一致性。使用七个区间对恶性病变数量进行分类，包含以下有序变量：0、1、2 - 5、6 - 10、11 - 20、>20可计数和弥漫性/不可计数。恶性病变数量的差异通过PET与CT以及PET与MRI之间区间水平的差异（“Δ区间”）获得，Δ区间越接近零意味着一致性率越高。
结果
纳入29例患者。原发性肿瘤包括17例胃肠胰神经内分泌肿瘤、1例结肠神经内分泌癌、7例肺神经内分泌肿瘤和2例脑膜瘤。MRI与PET的患者水平一致性为96%，CT与PET的为67%（P = 0.039）。MRI与PET的器官水平一致性为74%，CT与PET的为40%（P < 0.0001）。在骨骼中，MRI与PET的一致性率高于CT，分别为92%和33%（P = 0.016）。总体而言，PET/MRI平均Δ区间为0.5±1.1，PET/CT为1.4±1.2（P < 0.0001）。在肝脏中，PET/MRI平均Δ区间为0.0±1.1，PET/CT为1.7±1.2（P = 0.0078）。在骨骼中，PET/MRI的平均Δ区间比PET/CT更接近零，分别为0.6±1.4和2.0±1.5（P = 0.0098）。
结论
与SSTR PET/CT相比，SSTR PET/MRI在恶性肿瘤累及和恶性病变数量方面具有更高的患者和器官水平一致性，在骨骼和肝脏中尤其具有明显的附加价值。
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