鼻咽癌颅底骨侵犯的强化检测:18氟-氟化钠(18F-NaF)正电子发射断层扫描/计算机断层扫描(PET/CT)联合磁共振成像(MRI)的辅助诊断价值。

IF 2.9 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Quantitative Imaging in Medicine and Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-12 DOI:10.21037/qims-24-265
Meina Liang, Xufeng Guo, Chengmao Guo, Jingxing Xiao
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引用次数: 0

摘要

背景:鼻咽癌(NPC)起源于鼻咽侧壁的鼻咽粘膜。鼻咽癌治疗中的一个重大挑战是颅底骨侵犯(SBBI),它会影响预后和治疗计划。磁共振成像(MRI)是鼻咽癌患者 SBBI 的主要诊断工具;然而,由于颅底的复杂性和磁共振成像信号的重叠,SBBI 的检测可能具有挑战性。18氟-氟化钠(18F-NaF)正电子发射断层扫描/计算机断层扫描(PET/CT)是一种新兴的成像技术,在检测骨质病变方面显示出良好的前景。这项队列研究旨在评估 18F-NaF PET/CT 在检测鼻咽癌患者 SBBI 方面与单纯 MRI 相比的辅助诊断价值:方法:回顾性收集7天内进行的18F-NaF PET/CT和头颈部磁共振成像检查的成像数据。分别评估了 18F-NaF PET/CT、核磁共振成像以及两种方式联合检测 SBBI 的敏感性、特异性和准确性。比较采用了基于病灶和患者的分析方法。在比较这些方法的准确性时使用了 Cochran's Q 检验,而在进行配对比较时则使用了 Bonferroni 校正 McNemar 检验。数据分析使用 R 软件包,P0.05 为显著性水平:共有 164 名患者参与了研究。使用 18F-NaF PET/CT、核磁共振成像以及 18F-NaF PET/CT 与核磁共振成像联合模式,分别诊断出 97、84 和 94 例 SBBI。在患者层面,诊断效果(敏感性、特异性和准确性)如下:18F-NaF PET/CT 的灵敏度为 100%,特异度为 93.1%,准确率为 97.0%;MRI 的灵敏度为 90.2%,特异度为 98.6%,准确率为 93.9%;18F-NaF PET/CT 和 MRI 的组合灵敏度为 100%,特异度为 97.2%,准确率为 98.8%。18F-NaF PET/CT 联合 MRI 的准确率明显高于单独 MRI 的准确率(P=0.034)。使用 18F-NaF PET/CT、MRI 和 18F-NaF PET/CT 联合 MRI 分别诊断出 284、243 和 276 个 SBBI 病灶。病变水平的诊断效果(敏感性、特异性和准确性)如下:18F-NaF PET/CT 的灵敏度为 99.6%,特异度为 75.9%,准确度为 95.4%;MRI 的灵敏度为 88.2%,特异度为 93.1%,准确度为 89.1%;18F-NaF PET/CT 与 MRI 联合检查的灵敏度为 100%,特异度为 91.4%,准确度为 98.5%。18F-NaF PET/CT 与核磁共振成像联合使用的准确率比单独使用核磁共振成像的准确率显著提高,且差异具有统计学意义(PC 结论:18F-NaF PET/CT 与核磁共振成像联合使用的准确率比单独使用核磁共振成像的准确率显著提高,且差异具有统计学意义:联合使用18F-NaF PET/CT和MRI能明显提高鼻咽癌患者SBBI的诊断率,与单独使用MRI相比,联合方法提高了诊断的敏感性和准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enhanced detection of skull-base bone invasion in nasopharyngeal carcinoma: the supplementary diagnostic value of 18fluorine-sodium fluoride (18F-NaF) positron emission tomography/computed tomography (PET/CT) combined with magnetic resonance imaging (MRI).

Background: Nasopharyngeal carcinoma (NPC) originates in the nasopharyngeal mucosa, the lateral wall of the nasopharynx. A significant challenge in NPC management is skull-base bone invasion (SBBI), which affects prognosis and treatment planning. Magnetic resonance imaging (MRI) is the primary diagnostic tool for SBBI in NPC patients; however, the detection of SBBI can be challenging due to skull-base complexity and overlapping MRI signals. 18fluorine-sodium fluoride (18F-NaF) positron emission tomography/computed tomography (PET/CT) is an emerging imaging technique that has shown promise in detecting osseous lesions. This cohort study aimed to assess the supplementary diagnostic value of 18F-NaF PET/CT in detecting SBBI in NPC patients compared to that of MRI alone.

Methods: Imaging data were retrospectively collected from 18F-NaF PET/CT and head-and-neck MRI examinations conducted within a 7-day period. The sensitivity, specificity, and accuracy of 18F-NaF PET/CT, MRI, and the combination of both modalities in detecting SBBI were individually assessed. Both lesion- and patient-based analyses were employed for the comparison. Cochran's Q test was used to compare the accuracy of these methods, while the Bonferroni-corrected McNemar test was used for the pairwise comparisons. The data analysis was performed using the R software package, and a significance level of P<0.05 was considered statistically significant.

Results: A total of 164 patients were enrolled in the study. Using 18F-NaF PET/CT, MRI, and the combined modality of 18F-NaF PET/CT with MRI, 97, 84, and 94 cases of SBBI were diagnosed, respectively. At the patient level, the diagnostic efficacy (sensitivity, specificity, and accuracy) was as follows: 18F-NaF PET/CT had 100% sensitivity, 93.1% specificity, and 97.0% accuracy; MRI had 90.2% sensitivity, 98.6% specificity, and 93.9% accuracy; and the combination of 18F-NaF PET/CT and MRI had 100% sensitivity, 97.2% specificity, and 98.8% accuracy. The accuracy rate of 18F-NaF PET/CT combined with MRI were significantly higher than that of MRI alone (P=0.034). A total of 284, 243, and 276 SBBI lesions were diagnosed using 18F-NaF PET/CT, MRI, and 18F-NaF PET/CT combined with MRI, respectively. The diagnostic efficacy (sensitivity, specificity, and accuracy) at the lesion level was as follows: 18F-NaF PET/CT had 99.6% sensitivity, 75.9% specificity, and 95.4% accuracy; MRI had 88.2% sensitivity, 93.1% specificity, and 89.1% accuracy; and the combination of 18F-NaF PET/CT with MRI had 100% sensitivity, 91.4% specificity, and 98.5% accuracy. The combination of 18F-NaF PET/CT with MRI significantly improved the accuracy rate compared to that of MRI alone, and the difference was statistically significant (P<0.001).

Conclusions: The combined use of 18F-NaF PET/CT and MRI significantly enhanced the diagnosis of SBBI in NPC patients, and the combined method had improved diagnostic sensitivity and accuracy than MRI alone.

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来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.20
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17.90%
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252
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