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1.
Kazuhiro Kitajima Yuko Suenaga Yoshiko Ueno Tomonori Kanda Tetsuo Maeda Satoru Takahashi Yasuhiko Ebina Yoshiya Miyahara Hideto Yamada Kazuro Sugimura 《European journal of radiology》2013
Purpose
To investigate the diagnostic value of retrospective fusion of pelvic MRI and 18F-fluorodeoxyglucose (18F-FDG) PET images for assessment of locoregional extension and nodal staging of endometrial cancer.Materials and methods
Thirty patients with biopsy-proven endometrial cancer underwent preoperative contrast-enhanced PET/CT (PET/ceCT) and pelvic dynamic contrast-enhanced MRI for initial staging. Diagnostic performance of PET/ceCT, contrast-enhanced MRI, and retrospective image fusion from PET and MRI (fused PET/MRI) for assessing the extent of the primary tumor (T stage) and metastasis to regional LNs (N stage) was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.Results
Fused PET/MRI and MRI detected 96.7% of the primary tumors, whereas PET/ceCT detected 93.3%. Accuracy for T status was 80.0% for fused PET/MRI, and MRI proved significantly more accurate than PET/ceCT, which had an accuracy of 60.0% (p = 0.041). Patient-based sensitivity, specificity and accuracy for detecting pelvic nodal metastasis were 100%, 96.3% and 96.7% for both fused PET/MRI and PET/ceCT, and 66.7%, 100% and 96.7% for MRI, respectively. These three parameters were not statistically significant (p = 1).Conclusion
Fused PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for assessment of the primary tumor and nodal staging in patients with endometrial cancer. 相似文献2.
Leonardo Pace Emanuele Nicolai Angelo Luongo Marco Aiello Onofrio A. Catalano Andrea Soricelli Marco Salvatore 《European journal of radiology》2014
Purpose
To compare the performance of PET/MRI imaging using MR attenuation correction (MRAC) (DIXON-based 4-segment -map) in breast cancer patients with that of PET/CT using CT-based attenuation correction and to compare the quantification accuracy in lesions and in normal organ tissues.Methods
A total of 36 patients underwent a whole-body PET/CT scan 1 h after injection and an average of 62 min later a second scan using a hybrid PET/MRI system. PET/MRI and PET/CT were compared visually by rating anatomic allocation and image contrast. Regional tracer uptake in lesions was quantified using volumes of interest, and maximal and mean standardized uptake values (SUVmax and SUVmean, respectively) were calculated. Metabolic tumor volume (MTV) of each lesion was computed on PET/MRI and PET/CT. Tracer uptake in normal organ tissue was assessed as SUVmax and SUVmean in liver, spleen, left ventricular myocardium, lung, and muscle.Results
Overall 74 FDG positive lesions were visualized by both PET/CT and PET/MRI. No significant differences in anatomic allocation scores were found between PET/CT and PERT/MRI, while contrast score of lesions on PET/MRI was significantly higher. Both SUVmax and SUVmean of lesions were significantly higher on PET/MRI than on PET/CT, with strong correlations between PET/MRI and PET/CT data (ρ = 0.71–0.88). MTVs of all lesions were 4% lower on PET/MRI than on PET/CT, but no statistically significant difference was observed, and an excellent correlation between measurements of MTV with PET/MRI and PET/CT was found (ρ = 0.95–0.97; p < 0.0001). Both SUVmax and SUVmean were significantly lower by PET/MRI than by PET/CT for lung, liver and muscle, no significant difference was observed for spleen, while either SUVmax and SUVmean of myocardium were significantly higher by PET/MRI. High correlations were found between PET/MRI and PET/CT for both SUVmax and SUVmean of the left ventricular myocardium (ρ = 0.91; p < 0.0001), while moderate correlations were found for the other normal organ tissues (ρ = 0.36–0.61; p < 0.05).Conclusions
PET/MRI showed equivalent performance in terms of qualitative lesion detection to PET/CT. Despite significant differences in tracer uptake quantification, due to either methodological and biological factors, PET/MRI and PET/CT measurements in lesions and normal organ tissues correlated well. This study demonstrates that integrated whole-body PET/MRI is feasible in a clinical setting with high quality and in a short examination time. 相似文献3.
Karsten Beiderwellen Benedikt Gomez Christian Buchbender Verena Hartung Thorsten D. Poeppel Felix Nensa Hilmar Kuehl Andreas Bockisch Thomas C. Lauenstein 《European journal of radiology》2013
Objectives
To assess the value of PET/MRI with [18F]-FDG using a whole body protocol for the depiction and characterization of liver lesions in comparison to PET/CT.Methods
70 patients (31 women, 39 men) with solid tumors underwent [18F]-FDG PET/CT and followed by an additional PET/MRI using an integrated scanner. Two readers rated the datasets (PET/CT; PET/MRI) regarding conspicuity of hepatic lesions (4-point ordinal scale) and diagnostic confidence (5-point ordinal scale). Median scores for lesion conspicuity and diagnostic confidence were compared using Wilcoxon's rank sum test. Prior examinations, histopathology and clinical follow-up (116 ± 54 days) served as standard of reference.Results
36 of 70 (51%) patients showed liver lesions. Using PET/CT and PET/MRI all patients with liver metastases could correctly be identified. A total of 97 lesions were found (malignant n = 26; benign n = 71). For lesion conspicuity significantly higher scores were obtained for PET/MRI in comparison to PET/CT (p < 0.001). Significantly better performance for diagnostic confidence was observed in PET/MRI, both for malignant as for benign lesions (p < 0.001).Conclusions
PET/MRI, even in the setting of a whole body approach, provides higher lesion conspicuity and diagnostic confidence compared to PET/CT and may therefore evolve as an attractive alternative in oncologic imaging. 相似文献4.
Ayman I. Kamel Tamer F. Taha Ali Mohamed A. Tawab 《The Egyptian Journal of Radiology and Nuclear Medicine》2013
Purpose
The aim of this study was to investigate the potential impact of PET/CT on the initial staging of lymphoma with comparison to each of the PET and CT components alone.Materials and methods
PET/CTs from 37 patients with lymphoma undergoing initial staging were studied. Review of PET, CT and PET/CT images were done and staging of each patient by each modality was assigned and compared together. Clinical follow-up, additional imaging and histology served as the standard of reference.Results
PET/CT correctly diagnosed 83 nodal regions as positive for lymphomatous involvement versus 61 and 57 detected by PET and CT respectively. The respective sensitivities, specificities, and accuracies for the detection of nodal involvement were: PET: 88.4%, 65%, 94%, CT 89.1%, 60.1%, 96.1%, PET/CT 96.3%, 88.3%, 98.2%. PET/CT also correctly identified more extra-nodal lesions (n = 24) than CT (n = 16) and PET (n = 15). Correct staging was more accurate at PET/CT (n = 31) in comparison to PET alone (n = 23) and CT alone (n = 21).Conclusions
PET/CT was superior to PET and CT in the initial staging of lymphoma with significant better performance compared to PET and CT to clarify nodal and extra-nodal involved sites. The application of PET/CT rather than CT or PET is likely to be more beneficial. 相似文献5.
Philipp Heusch Christian Buchbender Karsten Beiderwellen Felix Nensa Verena Hartung-Knemeyer Thomas C. Lauenstein Andreas Bockisch Michael Forsting Gerald Antoch Till A. Heusner 《European journal of radiology》2013
Purpose
To compare maximum and mean standardized uptake values (SUVmax/mean) of normal organ tissues derived from [18F]-fluoro-desoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) using MR attenuation correction (MRAC) (DIXON-based 4-segment μ-map) with [18F]-FDG positron emission tomography/computed tomography (PET/CT) using CT-based attenuation correction (CTAC).Methods and materials
In 25 oncologic patients (15 men, 10 women; age 57 ± 13 years) after routine whole-body FDG-PET/CT (60 min after injection of 290 ± 40 MBq [18F]-FDG) a whole-body PET/MRI was performed (Magnetom Biograph mMR™, Siemens Healthcare, Erlangen, Germany). Volumes of interest of 1.0 cm3 were drawn in 7 physiological organ sites in MRAC-PET and the corresponding CTAC-PET images manually. Spearman correlation coefficients were calculated to compare MRAC- and CTAC based SUV values; Wilcoxon-Matched-Pairs signed ranks test was performed to test for potential differences.Results
The mean delay between FDG-PET/CT and PET/MRI was 92 ± 18 min. Excellent correlations of SUV values were found for the heart muscle (SUVmax/mean: R = 0.97/0.97); reasonably good correlations were found for the liver (R = 0.65/0.72), bone marrow (R = 0.42/0.41) and the SUVmax of the psoas muscle (R = 0.41). For subcutaneous fat, the correlation coefficient was 0.66 for SUVmean (p < 0.05). Correlations between MRAC and CTAC were non-significant for SUVmean of the psoas muscle, SUVmax of subcutaneous fat, SUVmax and SUVmean of the lungs, SUVmax and SUVmean of the blood-pool. The median SUVmax and SUVmean in MRAC-PET were lower than the respective CTAC values in all organs (p < 0.05) but heart (SUVmax) and the bone marrow (SUVmean).Conclusion
In conclusion, in oncologic patients examined with PET/CT and PET/MRI SUVmax and SUVmean values generally correlate well in normal organ tissues, except the lung, subcutaneous fat and the blood pool. SUVmax and SUVmean derived from PET/MRI can be used reliably in clinical routine. 相似文献6.
Mona A. El-Hariri Ghada K. Gouhar Ali M. Refat 《The Egyptian Journal of Radiology and Nuclear Medicine》2012
Purpose
The purpose of this study was to evaluate the role of integrated PET/CT in the staging of lung cancer compared with CT alone or PET alone.Materials and methods
Thirty-three patients underwent integrated PET/CT for the staging of lung cancer. The tumor, node and metastasis (TNM) stages were assessed with CT, PET and integrated PET–CT and compared with the surgical and pathological staging.Results
CT correctly evaluated the (T) status in (64%) of the patients, PET in (59%) and PET/CT in (86%). CT correctly evaluated the (N) status in (73%) of the patients, PET in (76%), and PET/CT (88%) with accuracy, sensitivity, specificity, PPV and NPV were 73%, 78%, 71%, 50% and 94% for CT, 76%, 67%, 79%, 55% and 95% for PET and 88%, 89%, 88%, 73% and 100% for PET/CT respectively, and for (M) status were 91%, 86%, 92%, 75% and 96% for CT, 88%, 71%, 92%, 71% and 92% for PET and 97%, 100%, 96%, 88% and 100% for PET/CT respectively. Regarding the overall TNM staging CT correctly staged 24 patients. PET correctly staged 23 cases while PET/CT correctly staged 30 cases. A significant difference in the accuracy of overall tumor staging between PET/CT and CT (P = 0.0412) or PET (P = 0.0233).Conclusion
The integrated PET/CT is superior to either CT or PET in the staging of lung cancer which has an important impact on selection of the appropriate treatment regimen. 相似文献7.
Halpern BS Yeom K Fueger BJ Lufkin RB Czernin J Allen-Auerbach M 《European journal of radiology》2007,62(2):199-204
Background
18F-FDG PET has a high accuracy for re-staging of head and neck cancer. The purpose of this study was to determine whether the diagnostic accuracy can be further improved with integrated PET/CT.Materials and methods
Forty-nine patients with a mean age of 59 ± 18 years were studied retrospectively. Histo-pathological verification was available either from complete tumor resection with or without lymph node dissection (n = 27) or direct endoscopic biopsy (n = 16) or ultrasound guided biopsy (n = 6). Two reviewers blinded to the pathological findings read all PET images in consensus. An experienced radiologist was added for the interpretation of the PET/CT images.Results
Tissue verification was available for 110 lesions in 49 patients. Sixty-seven lesions (61%) were biopsy positive and 43 (39%) were negative for malignant disease. PET and PET/CT showed an overall accuracy for cancer detection of 84 and 88% (p = 0.06), respectively. Sensitivity and specificity for PET were 78 and 93% versus 84 (p = NS) and 95% (p = NS) with PET/CT. A patient-by-patient analysis yielded a sensitivity, specificity and accuracy for PET of 80, 56 and 76%, compared to 88% (p = NS), 78% (p = NS) and 86% (p = 0.06) for PET/CT.Conclusion
The results of this study indicate that PET/CT does not significantly improve the detection of recurrence of head and neck cancer. However, a trend towards improved accuracy was observed (p = 0.06). 相似文献8.
Maura Miccò Hebert Alberto Vargas Irene A. Burger Marisa A. Kollmeier Debra A. Goldman Kay J. Park Nadeem R. Abu-Rustum Hedvig Hricak Evis Sala 《European journal of radiology》2014
Objective
To determine the associations of quantitative parameters derived from multiphase contrast-enhanced magnetic resonance imaging (CE-MRI), diffusion-weighted (DW) MRI and 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/computed tomography (PET/CT) with clinico-histopathological prognostic factors, disease-free survival (DFS) and overall survival (OS) in patients with cervical cancer.Methods and materials
Our institutional review board approved this retrospective study of 49 patients (median age, 45 years) with histopathologically proven IB-IVB International Federation of Gynecology and Obstetrics (FIGO) cervical cancer who underwent pre-treatment pelvic MRI and whole-body 18F-FDG PET/CT between February 2009 and May 2012. Maximum diameter (maxTD), percentage enhancement (PE) and mean apparent diffusion coefficient (ADCmean) of the primary tumor were measured on MRI. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT. Correlations between imaging metrics and clinico-histopathological parameters including revised 2009 FIGO stage, tumor histology, grade and lymph node (LN) metastasis at diagnosis were evaluated using the Wilcoxon rank sum test. Cox modeling was used to determine associations with DFS and OS.Results
Median follow-up was 17 months. 41 patients (83.6%) were alive. 8 patients (16.3%) died of disease. Progression/recurrence occurred in 17 patients (34.6%). Significant differences were observed in ADCmean, SUVmax, MTV and TLG according to FIGO stage (p < 0.001–0.025). There were significant correlations between ADCmean, MTV, TLG and LN metastasis (p = 0.017–0.032). SUVmax was not associated with LN metastasis. FIGO stage (p = 0.017/0.033), LN metastases (p = 0.001/0.020), ADCmean (p = 0.007/0.020) and MTV (p = 0.014/0.026) were adverse predictors of both DFS/OS. maxTD (p = 0.005) and TLG (p = 0.024) were adverse predictors of DFS. PE and SUVmax did not correlate with DFS or OS (p = 0.18–0.72).Conclusions
Quantitative parameters derived from pre-treatment DW-MRI (ADCmean) and from 18F-FDG PET/CT (MTV and TLG) were associated with high-risk features and may serve as prognostic biomarkers of survival in patients with cervical cancer. 相似文献9.
Kieran G. Foley Patrick Fielding Wyn G. Lewis Alex Karran David Chan Paul Blake S. Ashley Roberts 《European journal of radiology》2014
Purpose
18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) combined with computed tomography (PET/CT) is now established as a routine staging investigation of oesophageal cancer (OC). The aim of the study was to determine the prognostic significance of PET/CT defined tumour variables including maximum standardised uptake value (SUVmax), tumour length (TL), metastatic length of disease (MLoD), metabolic tumour volume (MTV), total lesion glycolysis (TLG) and total local nodal metastasis count (PET/CT LNMC).Materials and methods
103 pre-treatment OC patients (76 adenocarcinoma, 25 squamous cell carcinoma, 1 poorly differentiated and 1 neuroendocrine tumour) were staged using PET/CT. The prognostic value of the measured tumour variables were tested using log-rank analysis of the Kaplan–Meier method and Cox's proportional hazards method. Primary outcome measure was survival from diagnosis.Results
Univariate analysis showed all variables to have strong statistical significance in relation to survival. Multivariate analysis demonstrated three variables that were significantly and independently associated with survival; MLoD (HR 1.035, 95% CI 1.008–1.064, p = 0.011), TLG (HR 1.002, 95% CI 1.000–1.003, p = 0.018) and PET/CT LNMC (HR 0.048–0.633, 95% CI 0.005–2.725, p = 0.015).Conclusion
MLoD, TLG, and PET/CT LNMC are important prognostic indicators in OC. This is the first study to demonstrate an independent statistical association between TLG, MLoD and survival by multivariable analysis, and highlights the value of staging OC patients with PET/CT using functional tumour variables. 相似文献10.
Amarnath Jena Sangeeta Taneja Reema Goel Pushpendranath Renjen Pradeep Negi 《European journal of radiology》2014
Purpose
Simultaneous brain PET/MRI faces an important issue of validation of accurate MRI based attenuation correction (AC) method for precise quantitation of brain PET data unlike in PET/CT systems where the use of standard, validated CT based AC is routinely available. The aim of this study was to investigate the feasibility of evaluation of semiquantitative 18F-FDG PET parameters derived from simultaneous brain PET/MRI using ultrashort echo time (UTE) sequences for AC and to assess their agreement with those obtained from PET/CT examination.Methods
Sixteen patients (age range 18–73 years; mean age 49.43 (19.3) years; 13 men 3 women) underwent simultaneous brain PET/MRI followed immediately by PET/CT. Quantitative analysis of brain PET images obtained from both studies was undertaken using Scenium v.1 brain analysis software package. Twenty ROIs for various brain regions were system generated and 6 semiquantitative parameters including maximum standardized uptake value (SUV max), SUV mean, minimum SUV (SUV min), minimum standard deviation (SD min), maximum SD (SD max) and SD from mean were calculated for both sets of PET data for each patient. Intra-class correlation coefficients (ICCs) were determined to assess agreement between the various semiquantitative parameters for the two PET data sets.Results
Intra-class co-relation between the two PET data sets for SUV max, SUV mean and SD max was highly significant (p < 0.00) for all the 20 predefined brain regions with ICC > 0.9. SD from mean was also found to be statistically significant for all the predefined brain regions with ICC > 0.8. However, SUV max and SUV mean values obtained from PET/MRI were significantly lower compared to those of PET/CT for all the predefined brain regions.Conclusion
PET quantitation accuracy using the MRI based UTE sequences for AC in simultaneous brain PET/MRI is reliable in a clinical setting, being similar to that obtained using PET/CT. 相似文献11.
Ivan Platzek Bettina Beuthien-Baumann Matthias Schneider Volker Gudziol Hagen H. Kitzler Jens Maus Georg Schramm Manuel Popp Michael Laniado Jörg Kotzerke Jörg van den Hoff 《European journal of radiology》2014
Objective
To assess the diagnostic value of PET/MR (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for lymph node staging in head and neck cancer.Materials and methods
This prospective study was approved by the local ethics committee; all patients signed informed consent. Thirty-eight patients with squamous cell carcinoma of the head and neck region underwent a PET scan on a conventional scanner and a subsequent PET/MR on a whole-body hybrid system after a single intravenous injection of FDG. The accuracy of PET, MR and PET/MR for lymph node metastases were compared using receiver operating characteristic (ROC) analysis. Histology served as the reference standard.Results
Metastatic disease was confirmed in 16 (42.1%) of 38 patients and 38 (9.7%) of 391 dissected lymph node levels. There were no significant differences between PET/MR, MR and PET and MR (p > 0.05) regarding accuracy for cervical metastatic disease. Based on lymph node levels, sensitivity and specificity for metastatic involvement were 65.8% and 97.2% for MR, 86.8% and 97.0% for PET and 89.5% and 95.2% for PET/MR.Conclusions
In head and neck cancer, FDG PET/MR does not significantly improve accuracy for cervical lymph node metastases in comparison to MR or PET. 相似文献12.
Regional PET/CT after water gastric inflation for evaluating loco-regional disease of gastric cancer
Soo Jin Lee Won Woo Lee Hai-Jeon Yoon Ho-Young Lee Kyoung Ho Lee Young Hoon Kim Do Joong Park Hyung-Ho Kim Young So Sang Eun Kim 《European journal of radiology》2013
Objective
We aimed to improve diagnostic accuracy of 18F-fluoro-2-deoxyglucose (FDG) PET/CT for gastric cancer with water gastric inflation.Materials and methods
44 gastric cancer patients (M:F = 30:14, age ± std = 62.1 ± 14.5y) were enrolled before surgery. Fifty minutes after injection of FDG (0.14 mCi/kg body weight), whole body PET/CT was performed first and then regional PET/CT over gastric area was obtained 80 min post FDG injection after water gastric inflation. Diagnostic accuracies for loco-regional lesions were compared between whole body and regional PET/CT.Results
48 primary tumors (23 EGC and 25 AGC) and 348 LN stations (61 metastatic and 287 benign) in 44 patients were investigated. Primary tumor sensitivity of whole body PET/CT (50% = 24/48) was significantly improved by regional PET/CT (75% = 36/48, p < 0.005). Sensitivity of whole body PET/CT (24.6% = 15/61) for LN metastasis was also significantly improved by regional PET/CT (36.1% = 22/61, p < 0.01), whereas specificity of whole body PET/CT (99.3% = 285/287) was not compromised by regional PET/CT (98.3% = 282/287, p > 0.05). Higher primary tumor FDG uptake in regional PET/CT indicated shorter progress-free survival (p = 0.0003).Conclusion
Diagnostic accuracy of whole body PET/CT for loco-regional disease of gastric cancer could be significantly improved by regional PET/CT after water gastric inflation and prognosis could be effectively predicted by primary tumor FDG uptake in regional PET/CT. 相似文献13.
Takeo Kasuya Ukihide Tateishi Kazufumi Suzuki Hiromitsu Daisaki Yuji Nishiyama Masaharu Hata Tomio Inoue 《European journal of radiology》2013
Purpose
The aim of this study is to ascertain role of respiratory-gated PET/CT for accurate diagnosis of pancreatic tumors.Materials and methods
Prior to clinical study, the phantom study was performed to evaluate the impact of respiratory motion on lesion quantification. Twenty-two patients (mean age 65 years) with pancreatic tumors were enrolled. Pathological diagnoses by surgical specimens consisted of pancreatic cancer (n = 15) and benign intraductal papillary mucinous neoplasm (IPMN, n = 7). Whole-body scan of non-respiratory-gated PET/CT was performed at first, and subsequent respiratory-gated PET/CT for one bed position was performed. All PET/CT studies were performed prior to surgery. The SUV max obtained by non-respiratory-gated PET/CT and respiratory-gated PET/CT, and percent difference in SUVmax (%SUVmax) were compared.Results
The profile curve of 5 respiratory bin image was most similar to that of static image. The third bin of 5 respiratory bin image showed highest FWHM (24.0 mm) and FWTM (32.7 mm). The mean SUVmax of pancreatic cancer was similar to that of benign IPMN on non-respiratory-gated PET/CT (p = 0.05), whereas significant difference was found between two groups on respiratory-gated PET/CT (p = 0.016). The mean %SUV of pancreatic cancer was greater than that of benign IPMN (p < 0.0001). Identification of the primary tumor in pancreatic head (n = 13, 59%) was improved by using respiratory-gated PET/CT because of minimal affection of physiological accumulation in duodenum.Conclusion
Respiratory-gated PET/CT is a feasible technique for evaluation of pancreatic tumors and allows more accurate identification of pancreatic tumors compared with non-respiratory-gated PET/CT. 相似文献14.
Eun Young KimWon Jae Lee Dongil ChoiSoon Jin Lee Joon Young ChoiByung-Tae Kim Hyung Sik Kim 《European journal of radiology》2011,79(2):183-188
Aim
To date, no data are available on the use of PET/CT for preoperative staging of gastric cancer. We attempted to evaluate the value of PET/CT for preoperative staging of advanced gastric cancer, and to compare the use of PET/CT with contrast-enhanced CT (CECT).Materials and methods
We analyzed PET/CT of 78 patients with surgically proven advanced gastric cancer who had undergone preoperative CECT. Qualitative analysis was conducted by assessing the presence of primary tumors and metastases with PET/CT and CECT.Results
Among 71 patients who underwent a gastrectomy, 69 primary tumors (93%) were diagnosed by PET/CT, while 64 primary tumors (90%) were detected by CECT (p = 0.55). For regional lymph node metastasis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT vs. CECT were 41% vs. 25% (p = 0.00019), 100% vs. 92% (p = 0.31), 100% vs. 98% (p = 0.46), 26% vs. 42% (p = 0.14), and 51% vs. 72% (p = 0.00089), respectively.Conclusion
Overall, PET/CT showed comparable diagnostic performance to CECT in diagnosing primary tumors and regional lymph node metastases, though PET/CT was inferior to CECT for the sensitivity and accuracy in diagnosing regional lymph node metastases. Nevertheless, PET/CT would be useful when CECT findings were equivocal due to its high positive predictability. 相似文献15.
Purpose
Our aim was to clarify the diagnostic impact of contrast-enhanced (CE) 18F-fluorodeoxyglucose (FDG)–positron emission tomography (PET)/computed tomography (CT) for staging of pancreatic cancer compared to non-CE PET/CT.Method and materials
Between April 2006 and November 2009, a total of 95 patients (age range, 36–83 years [mean age, 67]) with primary pancreatic cancer underwent 18F-FDG PET/CT examinations. Diagnostic accuracy was compared between non-CE PET/CT and CE PET/CT. Images were analyzed visually and quantitatively by two blinded reviewers. Reference standard was histological examination in 48 patients (51%) and/or confirmation of an obvious progression in number and/or size of the lesions on follow-up CT examinations in 47 patients (49%).Results
For T-staging, invasion of duodenum (n = 20, 21%), mesentery (n = 12, 13%), and retroperitoneum (n = 13, 14%) was correctly diagnosed by both modalities. The ROC analyses revealed that the Az values of celiac artery (CA), common hepatic artery (CHA), splenic artery (SV), and superior mesenteric vein (SMV) invasion were significantly higher in the CE PET/CT group for both readers. Nodal metastasis was correctly diagnosed by CE PET/CT in 38 patients (88%) and by non-CE PET/CT in 45 patients (87%). Diagnostic accuracies of nodal metastasis in two modalities were similar. Using CE PET/CT, distant metastasis, scalene node metastasis, and peritoneal dissemination were correctly assigned in 39 patients (91%), while interpretation based on non-CE PET/CT revealed distant metastasis, scalene node metastasis, and peritoneal dissemination in 42 patients (81%). Diagnostic accuracy of distant metastasis, scalene node metastasis, and peritoneal dissemination with CE PET/CT was significantly higher than that of non-CE PET/CT (p < 0.05).Conclusion
CE PET/CT allows a more precise assessment of distant metastasis, scalene node metastasis, and peritoneal dissemination in patients with pancreatic cancer. 相似文献16.
Hwan Seo Lee Jae Seung Kim Jong-Lyel Roh Seung-Ho Choi Soon Yuhl Nam Sang Yoon Kim 《European journal of radiology》2014
Purpose
Fluorine 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in 18F-FDG uptake. However, both physiologic and abnormal lesions increase 18F-FDG uptake. Therefore, we evaluated 18F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake.Methods
A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including 18F-FDG PET/CT and biopsies. All lesions with abnormal HN 18F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal 18F-FDG uptake were calculated.Results
Abnormal 18F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal 18F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine tonsil (n = 2), and epiglottis (n = 1). The sensitivity and specificity of 18F-FDG PET/CT for identification of SPs were 75.0% and 98.7%, respectively.Conclusions
18F-FDG PET/CT is a reliable method for tumor staging and identify SP in HN region, promoting appropriate therapeutic planning. Additional examinations may be required to identify superficial or small-volume tumors. 相似文献17.
Moritz H. Albrecht Julian L. Wichmann Cindy Müller Theresa Schreckenbach Sreekanth Sakthibalan Renate Hammerstingl Wolf O. Bechstein Stephan Zangos Hanns Ackermann Thomas J. Vogl 《European journal of radiology》2014
Introduction
To compare the diagnostic performance and inter-observer reproducibility of CT and MRI in detecting colorectal liver metastases (CRLM) of observers with different levels of experience.Materials and methods
Data from 51 CT and 54 MRI examinations of 105 patients with CRLM were analysed. Intraoperative and histopathological findings served as the reference standard. Analyses were performed by four observers with varying levels of experience regarding imaging of CRLM (reviewers A, B, C and D with respectively >20, >5, <1 and 0 years of experience). Per-segment sensitivity, specificity, Cohen's kappa (κ) for diagnosed segments and Intra-class Correlation Coefficients (ICC) for reported number of lesions were calculated.Results
CT sensitivity and specificity was for reviewer A 89.71%/94.41%, B 78.50%/88.37%, C 63.55%/85.58%, D 84.11%/78.60% and regarding MRI A 90.40%/95.43%, B 74.40%/90.04%, C 60.00%/85.89% and D 65.60%/75.90%. The overall inter-observer agreement was higher for CT (κ = 0.43, p < 0.001; ICC = 0.75, p < 0.001) than MRI (κ = 0.38, p < 0.001; ICC = 0.65, p < 0.001). The experienced reviewers A and B achieved better agreement for MRI (κ = 0.54, p < 0.001; ICC = 0.77, p < 0.001) than CT (κ = 0.52, p < 0.00; ICC = 0.76, p < 0.001) unlike the less experienced C and D (MRI κ = 0.38, ICC = 0.63 and CT κ = 0.41, ICC = 0.74, respectively, p < 0.001).Conclusions
The proficiency in detection of CRLM is significantly influenced by observer experience, although CT interpretation is less affected than MRI analysis. 相似文献18.
Tessa Sieswerda-Hoogendoorn Floor A.M. Postema Dagmar Verbaan Charles B. Majoie Rick R. van Rijn 《European journal of radiology》2014
Objectives
To systematically review the literature on dating subdural hematomas (SDHs) on CT and MRI scans.Methods
We performed a systematic review in MEDLINE, EMBASE and Cochrane to search for articles that described the appearance of SDHs on CT or MRI in relation to time between trauma and scanning. Two researchers independently screened the articles, assessed methodological quality and performed data extraction. Medians with interquartile ranges were calculated. Differences were tested with a Mann–Whitney U or Kruskal–Wallis H test.Results
We included 22 studies describing 973 SDHs on CT and 4 studies describing 83 SDHs on MRI. Data from 17 studies (413 SDHs) could be pooled. There were significant differences between time intervals for the different densities on CT (p < 0.001). Time interval differed significantly between children and adults for iso- and hypodensity (p = 0.000) and hyperdensity (p = 0.046). Time interval did not differ significantly between abused and non-abused children. On MRI, time intervals for different signal intensities on T1 and T2 did not differ significantly (p = 0.108 and p = 0.194, respectively).Conclusions
Most time intervals of the different appearances of SDHs on CT and MRI are broad and overlapping. Therefore CT or MRI findings cannot be used to accurately date SDHs. 相似文献19.
Noha Hosam EL Din Behairy Tarek Ahmed Rafaat Amr Salah EL Din El Nayal Magdy Ibrahim Bassiouny 《The Egyptian Journal of Radiology and Nuclear Medicine》2014
Objective
To detect accuracy of PET/CT in the initial staging, response after the first line and end of treatment in early mediastinal lymphoma patients compared to contrast CT.Materials and methods
We studied 50 patients with pathologically proven lymphoma with a mean age = 27.5. All patients were at early stage. All patients performed CT and PET/CT for initial staging, after the first course of chemotherapy (after 4–6 weeks) and at the end of treatment (after 2–4 months).Results
PET/CT upstaged 5 cases. At first line of treatment, PET/CT and CECT were agreeable in 32% of cases. PET/CT showed 100% sensitivity, 96.7% specificity, 95% positive predictive value and 100% negative predictive value. At the end of treatment both methods showed a 46% agreement. PET/CT was statistically significant in the follow up of hilar and axillary lymph nodes. PET/CT showed 100% sensitivity and specificity; compared to 62.5% sensitivity and 97.6% specificity for CECT in detection of extra-nodal disease sites.Conclusion
PET/CT proved higher sensitivity and specificity over CECT. The major strength of PET/CT over CECT was its higher ability for detection of extra-nodal sites of lymphoma and excluding active disease in residual nodal mass lesions on follow up. 相似文献20.
Yoshiharu Ohno Mizuho Nishio Hisanobu Koyama Takeshi Yoshikawa Sumiaki Matsumoto Daisuke Takenaka Shinichiro Seki Maho Tsubakimoto Kazuro Sugimura 《European journal of radiology》2013