Detection of liver metastases from endocrine tumors: A prospective comparison of somatostatin receptor scintigraphy, computed tomography, and magnetic resonance imaging
Detection of liver metastases from endocrine tumors: A prospective comparison of somatostatin receptor scintigraphy, computed tomography, and magnetic resonance imaging
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DOI：
10.1200/jco.2005.01.013
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发表时间：
2005-01-01
影响因子：
45.3
通讯作者：
Baudin, E
中科院分区：
文献类型：
--
作者：
Dromain, C;de Baere, T;Baudin, E
目的比较生长抑素受体显像（SRS）、计算机断层扫描（CT）和磁共振成像（MRI）对高分化胃肠胰腺内分泌肿瘤（WDGEP ET）肝转移的诊断价值。定义“高灵敏度SRS”的预测因素。患者和方法64例WDGEP ET患者在15天内接受了腹部单光子发射计算机断层扫描（SPECT），螺旋CT和1.5-T MRI的SRS，其顺序是随机的。两名读者分析了每种模式的图像，盲目和independent.Results肝转移瘤存在于40的64例，并证实肝活检或手术后，分别在32和8例患者的病理。SRS、CT和MRI分别共检测到204、325和394个转移灶。MRI检测到的转移灶数量显著高于CT（P = 0.02）和SRS（P < 10（-4）），CT高于SRS（P < 10（-4））。SRS在7例CT和/或MRI阳性患者中为阴性。与静态视图相比，SPECT在10名患者中检测到更多病变。中位转移灶大小与SRS的敏感性显著相关（P = 0.04）。结论MRI对内分泌肿瘤肝转移的检出优于CT和SRS。我们建议在WDGEP ET初始分期和主要治疗事件之前进行肝脏MRI的系统性检查。SRS的低性能主要由转移大小对SRS检测能力的影响来解释。
Purpose To compare the respective sensitivity of somatostatin receptor scintigraphy (SRS), computed tomography (CT), and magnetic resonance imaging (MRI) in the detection of liver metastases from well-differentiated gastroenteropancreatic endocrine tumor (WDGEP ET) patients. To define predictive factors for "high-sensitivity SRS."Patients and Methods Sixty-four patients with WDGEP ET underwent SRS with abdominal single-photon emission computed tomography (SPECT), spiral CT, and 1.5-T MRI within a 15-day interval, the order of which was randomized. Two readers analyzed images of each modality, blindly and independently.Results Hepatic metastases were present in 40 of the 64 patients and confirmed by pathology after liver biopsy or surgery in 32 and eight patients, respectively. SRS, CT, and MRI detected a total of 204, 325, and 394 metastases, respectively. The number of detected metastases was significantly higher with MRI than with CT (P = .02) and SRS (P < 10(-4)) and higher with CT than with SRS (P < 10(-4)). SRS was negative in seven patients with a positive CT and/or MRI. More lesions were detected in 10 patients by SPECT compared with static views. The median metastasis size was significantly correlated (P = .04) with the sensitivity of SRS.Conclusion MRI seems to have an edge over CT and SRS for the detection of liver metastases from endocrine tumors. We recommend the systematic performance of liver MRI at WDGEP ET initial staging and before major therapeutic events. The low performance of SRS was mainly explained by the impact of the metastasis size on the detection capacity of SRS.