Abid Camelia, Tannoury Jenny, Uzzan Mathieu, Reizine Edouard, Mulé Sébastien, Chalaye Julia, Luciani Alain, Itti Emmanuel, Sobhani Iradj
Department of Gastroenterology, Henri Mondor Hospital, 1 Rue Gustave Eiffel, 94000 Creteil, France.
Department of Radiology, Henri Mondor Hospital, 94000 Creteil, France.
Cancers (Basel). 2024 Jun 28;16(13):2372. doi: 10.3390/cancers16132372.
Simultaneous positron emission tomography/magnetic resonance imaging (PET-MRI) combines the high sensitivity of PET with the high specificity of MRI and is a tool for the assessment of gastroenteropancreatic neuroendocrine neoplasms (G-NENs). However, it remains poorly evaluated with no clear recommendations in current guidelines. Thus, we evaluated the prognostic impact of PET-MRI in G-NEN patients.
From June 2017 to December 2021, 71 G-NEN patients underwent whole-body PET-MRI for staging and/or follow-up purposes. A whole-body emission scan with F-6-fluoro-L-dihydroxyphenylalanine (FDOPA, = 30), F-fluoro-2-deoxy-D-glucose (FDG, = 21), or Ga-(DOTA(0)-Phe(1)-Tyr(3))-octreotide (Ga-DOTATOC, = 20) with the simultaneous acquisition of a T1-Dixon sequence and diffusion-weighed imaging (DWI), followed by a dedicated step of MRI sequences with a Gadolinium contrast was performed. The patients underwent PET-MRI every 6-12 months during the follow-up period until death. Over this period, 50 patients with two or more PET-MRI were evaluated.
The mean age was 61 [extremes, 31-92] years. At the baseline, PET-MRI provided new information in 12 cases (17%) as compared to conventional imaging: there were more metastases in eight, an undescribed location (myocardia) in two, and an unknown primary location in two cases. G grading at the baseline influenced overall survival. During the follow-up (7-381 months, mean 194), clinical and therapy managements were influenced by PET-MRI in three (6%) patients due to new metastases findings when neither overall, nor disease-free survivals in these two subgroups ( = 12 vs. = 59), were different.
Our study suggests that using PET/MRI with the appropriate radiotracer improves the diagnostic performance with no benefit on survival. Further studies are warranted to evaluate the cost-effectiveness of this procedure.
正电子发射断层扫描/磁共振成像（PET-MRI）将PET的高灵敏度与MRI的高特异性相结合，是评估胃肠胰神经内分泌肿瘤（G-NENs）的一种工具。然而，目前对其评估仍不足，现行指南中也没有明确建议。因此，我们评估了PET-MRI对G-NEN患者的预后影响。
2017年6月至2021年12月，71例G-NEN患者接受了全身PET-MRI检查，用于分期和/或随访。进行了一次全身发射扫描，使用F-6-氟-L-二羟基苯丙氨酸（FDOPA，n = 30）、F-氟-2-脱氧-D-葡萄糖（FDG，n = 21）或镓（DOTA(0)-Phe(1)-Tyr(3)）-奥曲肽（Ga-DOTATOC，n = 20），同时采集T1-Dixon序列和扩散加权成像（DWI），随后进行使用钆对比剂的专用MRI序列检查。在随访期间，患者每6-12个月接受一次PET-MRI检查，直至死亡。在此期间，对50例接受过两次或更多次PET-MRI检查的患者进行了评估。
平均年龄为61岁[范围，31-92岁]。在基线时，与传统成像相比，PET-MRI在12例（17%）患者中提供了新信息：8例有更多转移灶，2例有未描述的部位（心肌），2例有不明原发部位。基线时的G分级影响总生存期。在随访期间（7-381个月，平均194个月），由于发现新的转移灶，PET-MRI对3例（6%）患者的临床和治疗管理产生了影响，而这两个亚组（n = 12 vs. n = 59）的总生存期和无病生存期并无差异。
我们的研究表明，使用合适的放射性示踪剂进行PET/MRI可提高诊断性能，但对生存期无益处。有必要进一步研究评估该检查的成本效益。
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