Comparison of whole-body PET/CT and PET/MRI in breast cancer patients: Lesion detection and quantitation of 18F-deoxyglucose uptake in lesions and in normal organ tissues
Comparison of whole-body PET/CT and PET/MRI in breast cancer patients: Lesion detection and quantitation of 18F-deoxyglucose uptake in lesions and in normal organ tissues
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DOI：
10.1016/j.ejrad.2013.11.002
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发表时间：
2014-02-01
影响因子：
3.3
通讯作者：
Salvatore, Marco
中科院分区：
文献类型：
--
作者：
Pace, Leonardo;Nicolai, Emanuele;Salvatore, Marco
目的：比较使用MR衰减校正（MRAC）的PET/MRI成像的性能（基于DIXON的4段图）与使用基于CT的衰减校正的PET/CT在乳腺癌患者中的定量准确性进行比较，并比较病变和正常器官组织中的定量准确性。共有36名患者在注射后1小时接受全身PET/CT扫描，平均62分钟后使用混合PET/MRI系统进行第二次扫描。PET/MRI和PET/CT通过分级解剖分配和图像对比度进行视觉比较。使用感兴趣的体积定量病灶中的区域示踪剂摄取，并计算最大和平均标准化摄取值（分别为SUVmax和SUVmean）。在PET/MRI和PET/CT上计算每个病灶的代谢肿瘤体积（MTV）。正常器官组织中的示踪剂摄取被评估为肝、脾、左心室心肌、肺和肌肉中的SUVmax和SUVmean。PET/CT和PERT/MRI之间的解剖分配评分无显著差异，而PET/MRI上的病灶对比度评分显著较高。PET/MRI上病变的SUVmax和SUVmean均显著高于PET/CT，PET/MRI和PET/CT数据之间具有强相关性（rho = 0.71-0.88）。PET/MRI上所有病变的MTV均比PET/CT低4%，但未观察到统计学显著差异，并且发现PET/MRI和PET/CT的MTV测量值之间具有良好的相关性（rho = 0.95-0.97; p < 0.0001）。PET/MRI显示肺、肝和肌肉的SUVmax和SUVmean均显著低于PET/CT，脾脏的SUVmax和SUVmean无显著差异，而心肌的SUVmax和SUVmean均显著高于PET/CT。PET/MRI和PET/CT对左心室心肌的SUVmax和SUVmean均具有高度相关性（rho = 0.91; p < 0.0001），而对其他正常器官组织的SUVmax和SUVmean具有中度相关性（rho = 0.36-0.61; p < 0.05）。尽管示踪剂摄取定量存在显著差异，但由于方法学和生物学因素，病变和正常器官组织中的PET/MRI和PET/CT测量结果相关性良好。本研究表明，一体化全身PET/MRI在临床环境中具有高质量和短检查时间的可行性。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Purpose: To compare the performance of PET/MRI imaging using MR attenuation correction (MRAC) (DIXON-based 4-segment -map) in breast cancer patients with that of PET/CT using CT-based attenuation correction and to compare the quantification accuracy in lesions and in normal organ tissues.Methods: A total of 36 patients underwent a whole-body PET/CT scan 1 h after injection and an average of 62 min later a second scan using a hybrid PET/MRI system. PET/MRI and PET/CT were compared visually by rating anatomic allocation and image contrast. Regional tracer uptake in lesions was quantified using volumes of interest, and maximal and mean standardized uptake values (SUVmax and SUVmean, respectively) were calculated. Metabolic tumor volume (MTV) of each lesion was computed on PET/MRI and PET/CT. Tracer uptake in normal organ tissue was assessed as SUVmax and SUVmean in liver, spleen, left ventricular myocardium, lung, and muscle.Results: Overall 74 FDG positive lesions were visualized by both PET/CT and PET/MRI. No significant differences in anatomic allocation scores were found between PET/CT and PERT/MRI, while contrast score of lesions on PET/MRI was significantly higher. Both SUVmax and SUVmean of lesions were significantly higher on PET/MRI than on PET/CT, with strong correlations between PET/MRI and PET/CT data (rho = 0.71-0.88). MTVs of all lesions were 4% lower on PET/MRI than on PET/CT, but no statistically significant difference was observed, and an excellent correlation between measurements of MTV with PET/MRI and PET/CT was found (rho = 0.95-0.97; p < 0.0001). Both SUVmax and SUVmean were significantly lower by PET/MRI than by PET/CT for lung, liver and muscle, no significant difference was observed for spleen, while either SUVmax and SUVmean of myocardium were significantly higher by PET/MRI. High correlations were found between PET/MRI and PET/CT for both SUVmax and SUVmean of the left ventricular myocardium (rho = 0.91; p < 0.0001), while moderate correlations were found for the other normal organ tissues (rho = 0.36-0.61; p < 0.05).Conclusions: PET/MRI showed equivalent performance in terms of qualitative lesion detection to PET/CT. Despite significant differences in tracer uptake quantification, due to either methodological and biological factors, PET/MRI and PET/CT measurements in lesions and normal organ tissues correlated well. This study demonstrates that integrated whole-body PET/MRI is feasible in a clinical setting with high quality and in a short examination time. (C) 2013 Elsevier Ireland Ltd. All rights reserved.