Abstract:
Hybrid PET-MRI systems are being used more frequently. One of the drawbacks of PET-MRI imaging is its inferiority in detecting lung nodules, so it is often combined with a computed tomography (CT) of the chest. However, chest CT often detects additional, indeterminate lung nodules. The objective of this study was to assess the sensitivity of detecting metastatic versus indeterminate nodules with PET-MRI compared to chest CT. A total of 328 patients were included. All patients had a PET/MRI whole-body scan for (re)staging of cancer combined with an unenhanced chest CT performed at our center between 2014 and 2020. Patients had at least a two-year follow-up. Six percent of the patients had lung metastases at initial staging. The sensitivity and specificity of PET-MRI for detecting lung metastases were 85% and 100%, respectively. The incidence of indeterminate lung nodules on chest CT was 30%. The sensitivity of PET-MRI to detect indeterminate lung nodules was poor (23.0%). The average size of the indeterminate lung nodules detected on PET-MRI was 7 ± 4 mm, and the missed indeterminate nodules on PET-MRI were 4 ± 1 mm (p < 0.001). The detection of metastatic lung nodules is fairly good with PET-MRI, whereas the sensitivity of PET-MRI for detecting indeterminate lung nodules is size-dependent. This may be an advantage, limiting unnecessary follow-up of small, indeterminate lung nodules while adequately detecting metastases.
摘要:
混合PET-MRI系统被更频繁地使用。PET-MRI成像的缺点之一是其在检测肺结节方面的劣势,所以它通常与胸部计算机断层扫描(CT)相结合。然而,胸部CT经常检测到额外的,不确定的肺结节。这项研究的目的是评估与胸部CT相比,使用PET-MRI检测转移性结节和不确定结节的敏感性。共纳入328名患者。所有患者在2014年至2020年期间在我们中心进行了PET/MRI全身扫描,以进行癌症(重新)分期,并进行了胸部CT增强。患者至少接受了两年的随访。6%的患者在初始阶段有肺转移。PET-MRI检测肺转移瘤的敏感性和特异性分别为85%和100%,分别。胸部CT上不确定的肺结节的发生率为30%。PET-MRI检测不确定肺结节的敏感性较差(23.0%)。在PET-MRI上检测到的不确定的肺结节的平均大小为7±4mm,在PET-MRI上遗漏的不确定结节为4±1mm(p<0.001)。PET-MRI对转移性肺结节的检测相当好,而PET-MRI检测不确定肺结节的敏感性是大小依赖性的。这可能是一个优势,限制不必要的小随访,不确定的肺结节,同时充分检测转移。