A proposal for combined MRI and PET/CT interpretation criteria for preoperative nodal staging in non-small-cell lung cancer
A proposal for combined MRI and PET/CT interpretation criteria for preoperative nodal staging in non-small-cell lung cancer
复制标题
DOI：
10.1007/s00330-012-2388-3
复制
发表时间：
2012-07-01
影响因子：
5.9
通讯作者：
Shim, Young Mog
中科院分区：
文献类型：
--
作者：
Kim, Yoo Na;Yi, Chin A.;Shim, Young Mog
为了确定在非小细胞肺癌（NSCLC）术前淋巴结分期时解读MRI和PET/CT联合图像时恶性淋巴结的阳性阅读标准，49例活检证实的NSCLC患者同时接受了PET/CT和胸部MRI [扩散加权成像（DWI）]。在PET/CT和MRI的联合解读中，通过应用包含性（如果其中一个读数为阳性，则为阳性）或排除性（如果两个读数均为阳性，则为阳性）标准评价每个淋巴结站是否存在转移。病理证实为结节期。PET/CT和MRI联合诊断的准确性在每个节点和每个病人的基础上进行了确定，并与PET/CT单独进行了比较。在49例患者中，206个节点中有39个（19%）含有恶性细胞。在206个节点站中，186个（90%）的读数一致，而其余（10%）的读数不一致。与单独PET/CT相比，联合PET/CT和MRI的纳入标准有助于提高检测淋巴结转移的敏感性（69（46%; P = 0.003），而在正常范围内，与PET/CT相比，MRI和PET/CT联合检查的纳入标准有助于显著提高检测淋巴结转移的敏感性。结论：MRI和PET/CT联合诊断可提高对淋巴结转移的检出率，MRI/PET/CT联合诊断的纳入标准结论：MRI与PET/CT联合应用可减少不必要的开胸手术，提高诊断淋巴结转移的敏感性。
To determine the positive reading criteria for malignant nodes when interpreting combined MRI and PET/CT images for preoperative nodal staging in non-small-cell lung cancer (NSCLC).Forty-nine patients with biopsy-proven NSCLC underwent both PET/CT and thoracic MRI [diffusion weighted imaging (DWI)]. Each nodal station was evaluated for the presence of metastasis by applying either inclusive (positive if either one read positive) or exclusive (positive if both read positive) criteria in the combined interpretation of PET/CT and MRI. Nodal stage was confirmed pathologically. The combined diagnostic accuracy of PET/CT and MRI was determined on per-nodal station and per-patient bases and compared with that of PET/CT alone.In 49 patients, 39 (19%) of 206 nodal stations harboured malignant cells. Out of 206 nodal stations, 186 (90%) had concordant readings, while the rest (10%) had discordant readings. Inclusive criteria of combined PET/CT and MRI helped increase sensitivity for detecting nodal metastasis (69%) compared with PET/CT alone (46%; P = 0.003), while specificity was not significantly decreased.Inclusive criteria in combined MRI and PET/CT readings help improve significantly the sensitivity for detecting nodal metastasis compared with PET/CT alone and may decrease unnecessary open thoracotomy.Key PointsaEuro cent Combined interpretation of MRI and PET/CT enhances the detection of nodal metastasis.aEuro cent Inclusive criteria of combined MRI/PET/CT improved the sensitivity for detecting nodal metastasis.aEuro cent Combined interpretation of MRI and PET/CT may reduce unnecessary open thoracotomies.