Radiology:FDG PET/MRI联合肝细胞特异性对比剂在直肠癌M分期的价值

2020-05-22 shaosai MedSci原创

PET/MRI在评价直肠癌远处转移(M分期)的价值与对比增强CT相比孰优孰劣尚不清楚。

背景

PET/MRI在评价直肠癌远处转移(M分期)的价值与对比增强CT相比孰优孰劣尚不清楚。

目的

本研究旨在比较氟18氟脱氧核糖(FDG)PET/MRI与胸腹部CT及直肠MRI在评价直肠癌临床M分期的价值差异。

材料与方法

本研究纳入了新诊的高级别中低位直肠癌的患者。患者均行FDG PET/MRI(包括肝脏和直肠MRI)、胸腹部CT检查(常规临床检查方案)。此后,以6个月临床随访或活检作为参考标准评价M分期的结果。比较两种方案的结果。并评估M分期的一致性。采用非参数检验进行统计学分析。

结果

本研究功能纳入了71例受试者。由于病变的不确定性共有22/71例患者(31%; 95% CI: 20.5%, 43.1%)通过常规临床检查方案不能明确其M分期。然而,在这些患者中,PET/MRI准确的识别了14例无转移(100%; 95% CI: 76.8%, 100%)及7/8例(88%; 95% CI: 47.4%, 99.7%)随访中发生转移的患者。PET/MRI在排除转移性病变较常规临床检查方案具有较高的特异性(98% [54/ 55例] vs 72% [40/55 例]; P < .001),并且不增加漏诊转移的患者(6% [1/16例] vs 6% [1/ 16例]; P > .99)。

结论

包含直肠和肝脏MRI的PET/MRI通过评价未知病变性质、转移有助于对新诊晚期直肠癌分期,其效果要由于对比增强CT检查,减少了额外的影像学检查。

原始出处:

Yoon JH, Lee JM, Chang W.et al. Initial M Staging of Rectal Cancer: FDG PET/MRI with a Hepatocyte-specific Contrast Agent versus Contrast-enhanced CT.

DOI:10.1148/radiol.2019190794

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    2020-11-26 xjy02
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    2020-08-18 feather89
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