Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard
Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard
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DOI：
10.1007/s00330-014-3114-0
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发表时间：
2014-05-01
影响因子：
5.9
通讯作者：
Nievelstein, Rutger A. J.
中科院分区：
文献类型：
--
作者：
Littooij, Annemieke S.;Kwee, Thomas C.;Nievelstein, Rutger A. J.
目的比较全身磁共振弥散加权成像(全身MRI-DWI)和FDG-PET/CT对儿童淋巴瘤的分期价值。33例患者(平均年龄13.9岁)顺利完成全身MRI-DWI检查。全身磁共振弥散加权成像由两名盲人独立评估。经过一致阅读，一个非盲目的专家小组评估了全身MRI-DWI和FDG-PET/CT的不同发现，并利用骨髓活检、其他影像数据和临床信息得出了基于FDG-PET/CT的参考标准。观察者间对全身MRI-DWI的一致性良好[所有结节位置一起(kappa=0.79)；所有结外位置一起(kappa=0.69)]。对于结节(kappa=0.91)和结外(kappa=0.94)分期，以全身MRI-DWI和FDG-PET/CT为基础的参考标准之间有很好的一致性。MRI-DWI对结节分期的敏感性和特异性分别为93%和98%，对结外分期的敏感性和特异性分别为89%和100%。在移除MRI读取器错误之后，结果表明，全身MRI-DWI对儿童淋巴瘤的分期是可行的，可以作为FDG-PET/CT的一种良好的无辐射替代方案。Euro cent准确的分期对于治疗计划和评估预后很重要。Euro全身MRI-DWI可能是FDG-PET/CT的良好的无辐射替代方案。全身MRI-DWI观察者间的一致性良好全身MRI与FDG-PET/CT参考标准之间的欧元一致性良好大多数差异是由MRI上尺寸测量的不佳精度造成的。
To compare whole-body MRI, including diffusion-weighted imaging (whole-body MRI-DWI), with FDG-PET/CT for staging newly diagnosed paediatric lymphoma.A total of 36 children with newly diagnosed lymphoma prospectively underwent both whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI was successfully performed in 33 patients (mean age 13.9 years). Whole-body MRI-DWI was independently evaluated by two blinded observers. After consensus reading, an unblinded expert panel evaluated the discrepant findings between whole-body MRI-DWI and FDG-PET/CT and used bone marrow biopsy, other imaging data and clinical information to derive an FDG-PET/CT-based reference standard.Interobserver agreement of whole-body MRI-DWI was good [all nodal sites together (kappa = 0.79); all extranodal sites together (kappa = 0.69)]. There was very good agreement between the consensus whole-body MRI-DWI- and FDG-PET/CT-based reference standard for nodal (kappa = 0.91) and extranodal (kappa = 0.94) staging. The sensitivity and specificity of consensus whole-body MRI-DWI were 93 % and 98 % for nodal staging and 89 % and 100 % for extranodal staging, respectively. Following removal of MRI reader errors, the disease stage according to whole-body MRI-DWI agreed with the reference standard in 28 of 33 patients.Our results indicate that whole-body MRI-DWI is feasible for staging paediatric lymphoma and could potentially serve as a good radiation-free alternative to FDG-PET/CT.aEuro cent Accurate staging is important for treatment planning and assessing prognosisaEuro cent Whole-body MRI-DWI could be a good radiation-free alternative to FDG-PET/CTaEuro cent Interobserver agreement of whole-body MRI-DWI is goodaEuro cent Agreement between whole-body MRI and the FDG-PET/CT reference standard is goodaEuro cent Most discrepancies were caused by suboptimal accuracy of size measurements on MRI.