Diagnostic Performance of Whole-Body MRI as a Tool for Cancer Screening in Children With Genetic Cancer-Predisposing Conditions
Diagnostic Performance of Whole-Body MRI as a Tool for Cancer Screening in Children With Genetic Cancer-Predisposing Conditions
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DOI：
10.2214/ajr.14.13663
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发表时间：
2015-08-01
影响因子：
5
通讯作者：
Chauvin, Nancy A.
中科院分区：
文献类型：
--
作者：
Anupindi, Sudha A.;Bedoya, Maria A.;Chauvin, Nancy A.
客观的。患有癌症易感疾病的儿童患癌症和死亡的风险增加。关于全身 MRI 作为儿童癌症筛查工具的实用性数据有限。在这项研究中，我们检查了全身 MRI 的诊断性能，作为癌症遗传风险增加儿童的肿瘤监测机制。材料和方法。 24 名平均年龄为 11.2 岁（范围为 2.1-18.2 岁）的儿童（6 名男孩和 18 名女孩）在 5 年期间接受了 50 次非增强全身 MRI 检查。对扫描进行回顾性审查并评估图像质量；执行的序列；以及是否存在骨质、软组织或实体器官异常。提示恶性肿瘤的结果按风险分层为低（患癌症的几率 < 20%）、中（20-80%）或高（> 80%）。 MRI 结果与医疗记录、活检结果或其他后续影像相关；活检和随访被认为是参考标准。结果。 50 次检查中有 48 次（96%）质量非常好。确定了九个可疑恶性肿瘤的发现，包括两个高风险、两个中度风险和五个低风险病变。活检证实一处高危病变为甲状腺乳头状癌，其余病变被视为非恶性。全身MRI的敏感性为100%；特异性，94%；阳性预测值，25%；和阴性预测值 (NPV)，100%。 结论。非增强全身 MRI 很安全，并且可以产生出色的图像。高灵敏度、特异性和 NPV 使全身 MRI 成为具有癌症遗传倾向的儿童的宝贵癌症筛查工具。
OBJECTIVE. Children with cancer-predisposing conditions are at increased risk to develop and die of cancer. Limited data exist on the utility of whole-body MRI as a cancer screening tool in children. In this study, we examined the diagnostic performance of whole-body MRI as a mechanism of tumor surveillance for children at increased genetic risk for cancer.MATERIALS AND METHODS. Twenty-four children (six boys and 18 girls) with a mean age of 11.2 years (range, 2.1-18.2 years) underwent 50 unenhanced whole-body MRI examinations over a 5-year period. Scans were retrospectively reviewed and assessed for image quality; sequences performed; and the presence of osseous, soft-tissue, or solid organ abnormalities. Findings suggestive of a malignancy were stratified by risk as low (< 20% chance for cancer), moderate (20-80%), or high (> 80%). MRI findings were correlated with medical records, biopsy results, or additional follow-up imaging; biopsy and follow-up were considered as the reference standards.RESULTS. Forty-eight of 50 (96%) examinations were of very good quality. Nine findings suspicious for malignancy were identified, including two high-risk, two moderate-risk, and five low-risk lesions. One high-risk lesion was proven by biopsy to be a papillary thyroid carcinoma, with the remaining lesions deemed nonmalignant. The sensitivity of whole-body MRI was 100%; specificity, 94%; positive predictive value, 25%; and negative predictive value (NPV), 100%.CONCLUSION. Unenhanced whole-body MRI is safe and produces excellent images. The high sensitivity, specificity, and NPV make whole-body MRI a valuable cancer screening tool in children with a genetic predisposition for cancer.