Junxia Cao, Yirui Xuanyuan, Yang You, Weifeng Zhang, Ang Xuan
Department of Medical Imaging, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
West China School of Medicine, Sichuan University, Chengdu, China.
Front Oncol. 2025 May 14;15:1519107. doi: 10.3389/fonc.2025.1519107. eCollection 2025.
To compare the diagnostic differences between total-body PET/CT (positron emission tomography/computed tomography) and PET/MR (positron emission tomography/magnetic resonance) in detecting liver metastases.
The study analyzed data from patients with malignancies who underwent both conventional total-body PET/CT and liver PET/MR imaging between June 2020 and December 2020. A total of 20 patients with confirmed liver metastases were included, 9 of whom also underwent 2-hour delayed imaging of the liver. Paired t-tests were used to compare the signal-to-noise ratio (SNR) and tissue-to-background ratio (T/B) between PET/MR and conventional total-body PET/CT. Wilcoxon non-parametric tests were used to compare the standardized uptake value maximum (SUVmax) between the two imaging modalities. The McNemar test was employed to assess diagnostic performance differences between PET/MR and conventional total-body PET/CT, as well as between PET/MR and 2-hour delayed total-body PET/CT.
A total of 20 patients with confirmed liver metastases were included, with 39 suspicious lesions identified, and 27 lesions confirmed as liver metastases through biopsy or follow-up. The sensitivity of total-body PET/CT was 66.7% (18/27), while PET/MR had a sensitivity of 96.3% (26/27). The specificity of total-body PET/CT was 83.3% (10/12), and PET/MR had a specificity of 91.7% (11/12). The McNemar test revealed a significant difference in diagnostic performance between the two modalities, with PET/MR outperforming conventional total-body PET/CT (p=0.016). In 9 patients who underwent 2-hour delayed total-body PET/CT, 10 suspicious lesions were identified, 8 of which were confirmed as liver metastases. The sensitivity of delayed total-body PET/CT was 75% (6/8), and PET/MR had a sensitivity of 87.5% (7/8). Both modalities had a specificity of 50% (1/2). The McNemar test for delayed imaging showed no statistically significant difference (p=1). Wilcoxon non-parametric testing showed that the SUVmax of total-body PET/CT was significantly higher than that of PET/MR (Z=-2.355, p=0.019). Paired t-tests indicated no significant differences in SNR (t=-1.565, p=0.156) and T/B ratio (t=-1.689, p=0.115) between the two modalities.
Total-body PET/CT demonstrated higher detector sensitivity compared to PET/MR. However, PET/MR showed superior diagnostic performance for detecting liver metastases. The delayed 2-hour PET/CT imaging could partially compensate for the lower diagnostic efficiency of conventional PET/CT compared to PET/MR.
比较全身正电子发射断层扫描/计算机断层扫描（PET/CT）与正电子发射断层扫描/磁共振成像（PET/MR）在检测肝转移瘤方面的诊断差异。
本研究分析了2020年6月至2020年12月期间接受常规全身PET/CT和肝脏PET/MR成像的恶性肿瘤患者的数据。共纳入20例确诊为肝转移瘤的患者，其中9例还接受了肝脏2小时延迟成像。采用配对t检验比较PET/MR与常规全身PET/CT之间的信噪比（SNR）和组织与本底比值（T/B）。采用Wilcoxon非参数检验比较两种成像方式之间的最大标准化摄取值（SUVmax）。采用McNemar检验评估PET/MR与常规全身PET/CT之间以及PET/MR与2小时延迟全身PET/CT之间的诊断性能差异。
共纳入20例确诊为肝转移瘤的患者，发现39个可疑病灶，其中27个病灶经活检或随访确诊为肝转移瘤。全身PET/CT的灵敏度为66.7%（18/27），而PET/MR的灵敏度为96.3%（26/27）。全身PET/CT的特异度为83.3%（10/12），PET/MR的特异度为91.7%（11/12）。McNemar检验显示两种方式在诊断性能上存在显著差异，PET/MR优于常规全身PET/CT（p = 0.016）。在9例接受2小时延迟全身PET/CT的患者中，发现10个可疑病灶，其中8个确诊为肝转移瘤。延迟全身PET/CT的灵敏度为75%（6/8），PET/MR的灵敏度为87.5%（7/8）。两种方式的特异度均为50%（1/2）。延迟成像的McNemar检验显示无统计学显著差异（p = 1）。Wilcoxon非参数检验显示全身PET/CT的SUVmax显著高于PET/MR（Z = -2.355，p = 0.019）。配对t检验表明两种方式在SNR（t = -1.565，p = 0.156）和T/B比值（t = -1.689，p = 0.115）方面无显著差异。
与PET/MR相比，全身PET/CT显示出更高的探测器灵敏度。然而，PET/MR在检测肝转移瘤方面表现出更好的诊断性能。2小时延迟PET/CT成像可部分弥补常规PET/CT与PET/MR相比诊断效率较低的问题。
