{"title":"在晚期非小细胞肺癌分期中,除 18 F-FDG PET/CT 外,全身 MRI(而非仅脑 MRI)的价值。","authors":"Hanna Holmstrand, M Lindskog, A Sundin, T Hansen","doi":"10.1186/s40644-025-00852-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is a common neoplasm with poor prognosis in advanced stages. The clinical work-up in patients with locally advanced NSCLC mostly includes <sup>18</sup>F-fluorodeoxyglucose positron emission tomography computed tomography (<sup>18</sup>F-FDG PET/CT) because of its high sensitivity for malignant lesion detection; however, specificity is lower. Diverging results exist whether whole-body MRI (WB-MRI) improves the staging accuracy in advanced lung cancer. Considering WB-MRI being a more time-consuming examination compared to brain MRI, it is important to establish whether or not additional value is found in detecting and characterizing malignant lesions. The purpose of this study is to investigate the value of additional whole-body magnetic resonance imaging, instead of only brain MRI, together with <sup>18</sup>F-FDG PET/CT in staging patients with advanced NSCLC planned for curative treatment.</p><p><strong>Material and methods: </strong>In a prospective single center study, 28 patients with NSCLC stage 3 or oligometastatic disease were enrolled. In addition to <sup>18</sup>F-FDG PET/CT, they underwent WB-MRI including the thorax, abdomen, spine, pelvis, and contrast-enhanced examination of the brain and liver. <sup>18</sup>F-FDG PET/CT and WB-MRI were separately evaluated by two blinded readers, followed by consensus reading in which the likelihood of malignancy was assessed in detected lesions. Imaging and clinical follow-up for at least 12 months was used as reference standard. Statistical analyses included Fischer's exact test and Clopped-Pearson.</p><p><strong>Results: </strong>28 patients (mean age ± SD 70.5 ± 8.4 years, 19 women) were enrolled. WB-MRI and FDG-PET/CT both showed maximum sensitivity and specificity for primary tumor diagnosis and similar sensitivity (p = 1.00) and specificity (p = 0.70) for detection of distant metastases. For diagnosis of lymph node metastases, WB-MRI showed lower sensitivity, 0.65 (95% CI: 0.38-0.86) than FDG-PET/CT, 1.00 (95% CI: 0.80-1.00) (p < 0.05), but similar specificity (p = 0.59).</p><p><strong>Conclusions: </strong>WB-MRI in conjunction with <sup>18</sup>F-FDG PET/CT provides no additional value over MRI of the brain only, in staging patients with advanced NSCLC.</p><p><strong>Trial registration: </strong>Registered locally and approved by the Uppsala University Hospital committee, registration number ASMR020.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"30"},"PeriodicalIF":3.5000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895332/pdf/","citationCount":"0","resultStr":"{\"title\":\"The value of whole-body MRI instead of only brain MRI in addition to 18 F-FDG PET/CT in the staging of advanced non-small-cell lung cancer.\",\"authors\":\"Hanna Holmstrand, M Lindskog, A Sundin, T Hansen\",\"doi\":\"10.1186/s40644-025-00852-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is a common neoplasm with poor prognosis in advanced stages. The clinical work-up in patients with locally advanced NSCLC mostly includes <sup>18</sup>F-fluorodeoxyglucose positron emission tomography computed tomography (<sup>18</sup>F-FDG PET/CT) because of its high sensitivity for malignant lesion detection; however, specificity is lower. Diverging results exist whether whole-body MRI (WB-MRI) improves the staging accuracy in advanced lung cancer. Considering WB-MRI being a more time-consuming examination compared to brain MRI, it is important to establish whether or not additional value is found in detecting and characterizing malignant lesions. The purpose of this study is to investigate the value of additional whole-body magnetic resonance imaging, instead of only brain MRI, together with <sup>18</sup>F-FDG PET/CT in staging patients with advanced NSCLC planned for curative treatment.</p><p><strong>Material and methods: </strong>In a prospective single center study, 28 patients with NSCLC stage 3 or oligometastatic disease were enrolled. In addition to <sup>18</sup>F-FDG PET/CT, they underwent WB-MRI including the thorax, abdomen, spine, pelvis, and contrast-enhanced examination of the brain and liver. <sup>18</sup>F-FDG PET/CT and WB-MRI were separately evaluated by two blinded readers, followed by consensus reading in which the likelihood of malignancy was assessed in detected lesions. Imaging and clinical follow-up for at least 12 months was used as reference standard. Statistical analyses included Fischer's exact test and Clopped-Pearson.</p><p><strong>Results: </strong>28 patients (mean age ± SD 70.5 ± 8.4 years, 19 women) were enrolled. WB-MRI and FDG-PET/CT both showed maximum sensitivity and specificity for primary tumor diagnosis and similar sensitivity (p = 1.00) and specificity (p = 0.70) for detection of distant metastases. For diagnosis of lymph node metastases, WB-MRI showed lower sensitivity, 0.65 (95% CI: 0.38-0.86) than FDG-PET/CT, 1.00 (95% CI: 0.80-1.00) (p < 0.05), but similar specificity (p = 0.59).</p><p><strong>Conclusions: </strong>WB-MRI in conjunction with <sup>18</sup>F-FDG PET/CT provides no additional value over MRI of the brain only, in staging patients with advanced NSCLC.</p><p><strong>Trial registration: </strong>Registered locally and approved by the Uppsala University Hospital committee, registration number ASMR020.</p>\",\"PeriodicalId\":9548,\"journal\":{\"name\":\"Cancer Imaging\",\"volume\":\"25 1\",\"pages\":\"30\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-03-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895332/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40644-025-00852-6\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40644-025-00852-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
The value of whole-body MRI instead of only brain MRI in addition to 18 F-FDG PET/CT in the staging of advanced non-small-cell lung cancer.
Background: Non-small cell lung cancer (NSCLC) is a common neoplasm with poor prognosis in advanced stages. The clinical work-up in patients with locally advanced NSCLC mostly includes 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT) because of its high sensitivity for malignant lesion detection; however, specificity is lower. Diverging results exist whether whole-body MRI (WB-MRI) improves the staging accuracy in advanced lung cancer. Considering WB-MRI being a more time-consuming examination compared to brain MRI, it is important to establish whether or not additional value is found in detecting and characterizing malignant lesions. The purpose of this study is to investigate the value of additional whole-body magnetic resonance imaging, instead of only brain MRI, together with 18F-FDG PET/CT in staging patients with advanced NSCLC planned for curative treatment.
Material and methods: In a prospective single center study, 28 patients with NSCLC stage 3 or oligometastatic disease were enrolled. In addition to 18F-FDG PET/CT, they underwent WB-MRI including the thorax, abdomen, spine, pelvis, and contrast-enhanced examination of the brain and liver. 18F-FDG PET/CT and WB-MRI were separately evaluated by two blinded readers, followed by consensus reading in which the likelihood of malignancy was assessed in detected lesions. Imaging and clinical follow-up for at least 12 months was used as reference standard. Statistical analyses included Fischer's exact test and Clopped-Pearson.
Results: 28 patients (mean age ± SD 70.5 ± 8.4 years, 19 women) were enrolled. WB-MRI and FDG-PET/CT both showed maximum sensitivity and specificity for primary tumor diagnosis and similar sensitivity (p = 1.00) and specificity (p = 0.70) for detection of distant metastases. For diagnosis of lymph node metastases, WB-MRI showed lower sensitivity, 0.65 (95% CI: 0.38-0.86) than FDG-PET/CT, 1.00 (95% CI: 0.80-1.00) (p < 0.05), but similar specificity (p = 0.59).
Conclusions: WB-MRI in conjunction with 18F-FDG PET/CT provides no additional value over MRI of the brain only, in staging patients with advanced NSCLC.
Trial registration: Registered locally and approved by the Uppsala University Hospital committee, registration number ASMR020.
Cancer ImagingONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
7.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍:
Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology.
The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include:
Breast Imaging
Chest
Complications of treatment
Ear, Nose & Throat
Gastrointestinal
Hepatobiliary & Pancreatic
Imaging biomarkers
Interventional
Lymphoma
Measurement of tumour response
Molecular functional imaging
Musculoskeletal
Neuro oncology
Nuclear Medicine
Paediatric.