Demiroglu Bilim University, İstanbul, Turkey.
Derpartment of Radiology, Florence Nigtingale Hospitals, İstanbul, Turkey.
Radiol Oncol. 2024 Nov 28;58(4):494-500. doi: 10.2478/raon-2024-0062. eCollection 2024 Dec 1.
Whole-body positron emission tomography/magnetic resonance imaging (WB-PET/MRI) is increasingly used in the initial evaluation of oncology patients. The purpose of this study was to compare the diagnostic performance of WB MRI sequences, attenuation-corrected raw data positron-emission tomography (AC PET), and PET/MRI fused images to detect bone metastases.
We included 765 consecutive oncologic patients who received WB-PET/MRI from between January 2017 and September 2023. The presence of bone metastases was assessed using the individual sequences by two radiologists. Interobserver agreement was calculated. A receiver operating characteristic (ROC) analysis was performed to assess the performance of each individual sequence and fused images.
Interobserver agreement for the detection of bone metastases on all sequences ranged from good to very good. The reading of the combination of MRI sequences with PET images showed statistically significantly better performance than the reading of individual MRI sequences and PET component only. Contrast enhanced T1 W Volume-interpolated breath-hold examination (CE T1W VIBE) sequence superior to PET for the detection of bone metastasis, but the statistical significance was not as high as with T1W-PET and CE T1W-PET fused images. The highest performance was achieved by the fused CE T1W-PET images with sensitivity of 100%, specificity of 92%, PPV of 96%, and NPV of 100%.
The combination of these CE T1W VIBE sequences with PET images have the highest diagnostic performance in detecting bone metastases in oncologic patients. This sequence should be integrated in WB-PET/MRI acquisitions for initial staging of cancer.
全身正电子发射断层扫描/磁共振成像（WB-PET/MRI）越来越多地用于肿瘤患者的初始评估。本研究的目的是比较 WB MRI 序列、衰减校正原始数据正电子发射断层扫描（AC PET）和 PET/MRI 融合图像在检测骨转移方面的诊断性能。
我们纳入了 2017 年 1 月至 2023 年 9 月期间连续接受 WB-PET/MRI 检查的 765 例肿瘤患者。两名放射科医生使用单独的序列评估骨转移的存在情况。计算了观察者间的一致性。进行了接收器操作特征（ROC）分析，以评估每个单独序列和融合图像的性能。
在所有序列上检测骨转移的观察者间一致性从良好到非常好。与单独阅读 MRI 序列和仅阅读 PET 组件相比，阅读 MRI 序列与 PET 图像的组合显示出统计学上显著更好的性能。与 T1W-PET 和 CE T1W-PET 融合图像相比，对比增强 T1W 容积内插屏气检查（CE T1W VIBE）序列对检测骨转移具有更好的性能，但统计学意义不如 T1W-PET 和 CE T1W-PET 融合图像高。融合的 CE T1W-PET 图像具有最高的性能，灵敏度为 100%，特异性为 92%，PPV 为 96%，NPV 为 100%。
这些 CE T1W VIBE 序列与 PET 图像的组合在检测肿瘤患者的骨转移方面具有最高的诊断性能。该序列应整合到 WB-PET/MRI 采集中，用于癌症的初始分期。
