PET/MRI for the evaluation of patients with lymphoma: initial observations.
PET/MRI for the evaluation of patients with lymphoma: initial observations.
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DOI：
10.2214/ajr.14.13181
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Chandarana H
中科院分区：
文献类型：
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作者：
Heacock L;Weissbrot J;Raad R;Campbell N;Friedman KP;Ponzo F;Chandarana H
本研究的目的是评估最近引入的混合PET/MRI在使用PET/CT作为参考标准评价淋巴瘤患者中的作用。在这项前瞻性研究中，28例连续淋巴瘤患者（18例男性，10例女性;平均年龄53.6岁）接受了临床指征PET/ CT，随后使用PET/ CT研究的残留FDG活性进行PET/MRI成像。盲态阅片者分别评价PET/CT（参考标准）、PET/MRI和弥散加权成像（DWI）研究;对于每项研究，他们评估了淋巴结和结受累情况。在DWI、PET/MRI和PET/CT上标记并比较每个FDG-avid淋巴结站。采用改良安阿伯（AnnArbor）分期，比较PET/MRI和PET/CT的分期结果。将PET/MRI上FDG-亲合性淋巴结病变的最大标准化摄取值（SUVmax）与PET/CT上的SUVmax进行比较。将FDG-亲合淋巴结病变的表观扩散系数（ADC）与PET/MRI上的SUVmax进行比较。PET/CT在13例患者中确定了51个FDG-亲合淋巴结组。PET/MRI识别了其中51个淋巴结组，灵敏度为100%。DWI识别了32个淋巴结组，敏感性为62.7%。PET/MRI分期与PET/CT分期一致率为96.4%。对于1例分期结果不一致的患者，根据PET/MRI发现的骨髓受累（PET/CT漏诊），疾病被正确地提前至IV期。64.3%的患者DWI分期与PET/CT分期一致。PET/MRI相对于DWI的分期准确性显著增加（p = 0.004）。PET/MRI和PET/CT测量的SUVmax显示出极好的统计学显著相关性（r = 0.98，p < 0.001）。ADC和SUVmax之间的负相关性较差（r =-0.036，p = 0.847）。PET/MRI可用于评估淋巴瘤的疾病负担，其敏感性与PET/CT相似，并且可以作为淋巴瘤分期和随访的可行替代方案。
The objective of our study was to assess the role of recently introduced hybrid PET/MRI in the evaluation of lymphoma patients using PET/CT as a reference standard. In this prospective study 28 consecutive lymphoma patients (18 men, 10 women; mean age, 53.6 years) undergoing clinically indicated PET/ CT were subsequently imaged with PET/MRI using residual FDG activity from the PET/ CT study. Blinded readers evaluated PET/CT (reference standard), PET/MRI, and diffusion-weighted imaging (DWI) studies separately; for each study, they assessed nodal and extranodal involvement. Each FDG-avid nodal station was marked and compared on DWI, PET/MRI, and PET/CT. Modified Ann Arbor staging was performed and compared between PET/MRI and PET/CT. The maximum standardized uptake value (SUVmax) on PET/MRI for FDG-avid nodal lesions was compared with the SUVmax on PET/CT. The apparent diffusion coefficient (ADC) for FDG-avid nodal lesions was compared to SUVmax on PET/MRI. Fifty-one FDG-avid nodal groups were identified on PET/CT in 13 patients. PET/MRI identified 51 of these nodal groups with a sensitivity of 100%. DWI identified 32 nodal groups for a sensitivity of 62.7%. PET/MRI staging and PET/CT staging were concordant in 96.4% of patients. For the one patient with discordant staging results, disease was correctly upstaged to stage IV on the basis of the PET/MRI finding of bone marrow involvement, which was missed on PET/CT. DWI staging was concordant with PET/CT staging in 64.3% of the patients. The increased staging accuracy of PET/MRI relative to DWI was significant (p = 0.004). SUVmax measured on PET/MRI and PET/CT showed excellent statistically significant correlation (r = 0.98, p < 0.001). There was a poor negative correlation between ADC and SUVmax (r = −0.036, p = 0.847). PET/MRI can be used to assess disease burden in lymphoma with sensitivity similar to PET/CT and can be a viable alternative for lymphoma staging and follow-up.