ABSTRACT
Objetivo Comparar el rendimiento diagnóstico de la PET/RM con [18F]FDG y la PET/TC de forma preliminar en relación con la estadificación torácica del cáncer de pulmón de células no pequeñas (CPCNP) con un enfoque especial en la evaluación de la invasión pleural. Métodos Se incluyeron 52 pacientes con CPCNP con confirmación histopatológica y sometidos a seguimiento durante un año más. Se realizó una PET/TC con [18F]FDG de cuerpo entero y a continuación una PET/RM torácica para la estadificación torácica inicial. Las imágenes de PET/RM torácica se adquirieron simultáneamente e incluyeron secuencias potenciadas en T2, con y sin saturación grasa, en T1 y de difusión. Dos radiólogos evaluaron de forma independiente la estadificación T, N torácica y la afectación pleural. Se utilizó la prueba de Chi-cuadrado de McNemar para comparar las diferencias entre PET/TC y PET/RM en los criterios de evaluación. Se realizó análisis ROC de eficacia diagnóstica con calculó del área bajo la curva (AUC) para el estudio de la invasión pleural. Resultados La PET/RM mostró una mayor sensibilidad y especificidad en la detección de invasión pleural respecto a la PET/TC; 82 vs. 64% (p=0,625), 98 vs. 95% (p=1.000). Los resultados del análisis ROC de la PET/TC vs. la PET/RM respecto a la invasión pleural fueron los siguientes: AUCPET/TC=0,79, AUCPET/RM=0,90, p=0,21. Los resultados de la estadificación T y N fueron casi idénticos en la PET/TC y la PET/RM. Las diferencias existentes entre la PET/TC y la PET/RM para la estadificación T y N y la precisión de la invasión pleural no fueron estadísticamente significativas (p>0,05 en cada una). Conclusión La PET/RM y la PET/TC demostraron un rendimiento equivalente en la evaluación de la estadificación torácica preoperatoria de los pacientes con CPCNP (AU)
Objective To compare the diagnostic performance of 18F-FDG PET/MR and PET/CT preliminarily for the thoracic staging of non-small cell lung cancer (NSCLC) with a special focus on pleural invasion evaluation. Methods Fifty-two patients with pathologically confirmed NSCLC were included and followed for another year. Whole-body 18F-FDG PET/CT and subsequent thoracic PET/MR were performed for initial thoracic staging. Thoracic (simultaneous) PET/MR acquired PET images and MRI sequences including T2 weighted imaging, with and without fat saturation, T1 weighted imaging, and diffusion weighted imaging. Two radiologists independently assessed the thoracic T, N staging and pleural involvement. The McNemar Chi-square test was used to compare the differences between PET/CT and PET/MR in the criteria. The area under the receiver-operating-characteristic curves (AUC) was calculated. Result Compared to PET/CT, PET/MR exhibited higher sensitivity, specificity in the detection of pleural invasion; 82% vs. 64% (P=.625), 98% vs. 95% (P=1.000), PET/MR to PET/CT, respectively. The receiver-operating-characteristic analysis results of PET/CT vs. PET/MR for the pleural invasion were as follow: AUCPET/CT=0.79, AUCPET/MR=0.90, P=.21. Both T staging results and N staging results were approximately identical in PET/CT and PET/MR. Differences between PET/CT and PET/MR in T staging, N staging as well as pleural invasion accuracy were not statistically significant (P>.05, each). Conclusion PET/MR and PET/CT demonstrated equivalent performance about the evaluation of preoperative thoracic staging of NSCLC patients. PET/MR may have greater potential in pleural invasion evaluation for NSCLC, especially for solid nodules, crucial to clinical decision-making, though our results did not demonstrate statistical significance (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Fluorodeoxyglucose F18 , Magnetic Resonance Imaging , Neoplasm Staging , Positron Emission Tomography Computed Tomography/methods , Tomography, X-Ray Computed , Neoplasm InvasivenessABSTRACT
OBJECTIVE: To compare the diagnostic performance of 18F-FDG PET/MR and PET/CT preliminarily for the thoracic staging of non-small cell lung cancer (NSCLC) with a special focus on pleural invasion evaluation. METHODS: 52 patients with pathologically confirmed NSCLC were included and followed for another year. Whole-body 18F-FDG PET/CT and subsequent thoracic PET/MR were performed for initial thoracic staging. Thoracic (simultaneous) PET/MR acquired PET images and MRI sequences including T2 weighted imaging, with and without fat saturation, T1 weighted imaging, and diffusion weighted imaging (DWI). Two radiologists independently assessed the thoracic T, N staging and pleural involvement. The McNemar Chi-square test was used to compare the differences between PET/CT and PET/MR in the criteria. The area under the receiver-operating-characteristic curves (AUC) was calculated. RESULTS: Compared to PET/CT, PET/MR exhibited higher sensitivity, specificity in the detection of pleural invasion; 82 % vs. 64% (pâ¯=â¯0.625), 98 % vs. 95% (pâ¯=â¯1.000), PET/MR to PET/CT respectively. The receiver-operating-characteristic analysis results of PET/CT vs PET/MR for the pleural invasion were as follow: AUCPET/CTâ¯=â¯0.79, AUCPET/MRâ¯=â¯0.90, pâ¯=â¯0.21. Both T staging results and N staging results were approximately identical in PET/CT and PET/MR. Differences between PET/CT and PET/MR in T staging, N staging as well as pleural invasion accuracy were not statistically significant (pâ¯>â¯0.05, each). CONCLUSION: PET/MR and PET/CT demonstrated equivalent performance about the evaluation of preoperative thoracic staging of NSCLC patients. PET/MR may have greater potential in pleural invasion evaluation for NSCLC, especially for solid nodules, crucial to clinical decision-making, though our results did not demonstrate statistical significance.
