Lancet Oncol:儿童癌症分期检查,全身MRI可代替PET/CT

2014-03-05 佚名 医学专业新闻

背景:影像检查对癌症患儿的分期至关重要。然而,CT和含有放射指示剂的影像学检查手段增加了暴露在电离辐射下的可能性,从而增加了癌症复发的风险。我们旨在建立一种高效且适用于临床、无电离辐射的癌症分期检查方法——磁共振全身弥散成像(whole-body diffusion-weighted MRI),其造影剂为铁补充剂纳米氧化铁。方法:这是项前瞻性非随机分组单中心研究。纳入研究的患儿均患有恶性淋巴瘤或肉

背景:影像检查对癌症患儿的分期至关重要。然而,CT和含有放射指示剂的影像学检查手段增加了暴露在电离辐射下的可能性,从而增加了癌症复发的风险。我们旨在建立一种高效且适用于临床、无电离辐射的癌症分期检查方法——磁共振全身弥散成像(whole-body diffusion-weighted MRI),其造影剂为铁补充剂纳米氧化铁。

方法:这是项前瞻性非随机分组单中心研究。纳入研究的患儿均患有恶性淋巴瘤或肉瘤,全身MRI与18F-FDG PET/CT对患儿全身解剖部位进行扫描。肿瘤分期数据结果使用κ统计分析对比。标准参考为组织病理学检查和随访期间的影像学检查。

结果:招募的23名患者中有1人因未完成全身扫描而排除,22人数据得到分析。18F-FDG PET/CT相关的平均电离辐射暴露量为12·5 mSv,而磁共振全身弥散成像则为零。在1325处解剖部位中,18F-FDG PET/CT共发现174处病灶中的163处,而磁共振全身弥散成像则为158处。二者比较,敏感度为93·7% vs 90·8%;特异性为97·7% vs 99·5%;诊断准确度为97·2% vs 98·3%。两种造影方法所得到的疾病分期结论具有很高的一致性。未记录到造影剂纳米氧化铁相关的不良事件。

原始出处:

Klenk C1, Gawande R1, Uslu L1, Khurana A1, Qiu D1, Quon A1, Donig J1, Rosenberg J1, Luna-Fineman S2, Moseley M1, Daldrup-Link HE3.Ionising radiation-free whole-body MRI versus 18F-fluorodeoxyglucose PET/CT scans for children and young adults with cancer: a prospective, non-randomised, single-centre study.Lancet Oncol. 2014 Feb 18. pii: S1470-2045(14)70021-X. doi: 10.1016/S1470-2045(14)70021-X.

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    2014-05-18 howi
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    2014-10-22 feather89
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