1型神经纤维瘤病良性、非典型和恶性周围神经鞘肿瘤的鉴别——正电子发射计算机断层扫描与扩散加权磁共振成像的个体比较

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2024-12-27 DOI:10.1186/s13550-024-01189-0

Inka Ristow, Ivayla Apostolova, Michael G Kaul, Maria Stark, Antonia Zapf, Marie-Lena Schmalhofer, Victor F Mautner, Said Farschtschi, Gerhard Adam, Peter Bannas, Johannes Salamon, Lennart Well

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引用次数: 0

摘要

背景：在一项非效性设计中，比较正电子发射计算机断层扫描（F-18-FDG-PET/CT）和扩散加权磁共振成像（DW-MRI）对1型神经纤维瘤病（NF1）患者周围神经鞘肿瘤良性（BPNST）、非典型（ANF）或恶性（MPNST）的诊断性能。结果：在这项前瞻性单中心研究中，34例NF1患者(18例男性；30±11岁)在3T行F-18-FDG-PET/CT和多b值DW-MRI （11 b值0 - 800 s/mm²）检查。66个病灶对应39个BPNST， 11个ANF和16个MPNST进行了评估。两名放射科医生独立评估了最大标准化摄取值（SUVmax）、平均和最小表观扩散系数（ADCmean/min）以及每个病变中最低信号强度区域的ADC （ADCdark）。比较DW-MRI和F-18-FDG-PET/CT的aus，确定ADC是否不劣于SUVmax（非劣效裕度为-10%）。随访≥24个月（BPNST）或组织病理学评价（MPNST + ANF）作为诊断参考标准。SUVmax和ADC参数均显示出良好的诊断准确性(AUCSUVmax为94.0%；AUCADCmean/min/dark 91.6% / 90.1% / 92.5%)。然而，三个ADC参数中的任何一个都不能证明非劣效性（ADCmean/min/dark与SUVmax AUC差异的置信区间下限为-12.9% / -14.5% / -11.6%）。两种成像技术的内部信度都很好（Krippendorff's alpha均为0.94）。结论：PET/ ct衍生的SUVmax和mri衍生的ADC都可以对良性和（前）恶性周围神经鞘肿瘤进行敏感和无创的区分。然而，在这项前瞻性单中心研究中，DW-MRI不能被认为不次于F-18-FDG-PET/CT。

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Discrimination of benign, atypical, and malignant peripheral nerve sheath tumours in neurofibromatosis type 1 - intraindividual comparison of positron emission computed tomography and diffusion-weighted magnetic resonance imaging.

Background: To intraindividually compare the diagnostic performance of positron emission computed tomography (F-18-FDG-PET/CT) and diffusion-weighted magnetic resonance imaging (DW-MRI) in a non-inferiority design for the discrimination of peripheral nerve sheath tumours as benign (BPNST), atypical (ANF), or malignant (MPNST) in patients with neurofibromatosis type 1 (NF1).

Results: In this prospective single-centre study, thirty-four NF1 patients (18 male; 30 ± 11 years) underwent F-18-FDG-PET/CT and multi-b-value DW-MRI (11 b-values 0 - 800 s/mm²) at 3T. Sixty-six lesions corresponding to 39 BPNST, 11 ANF, and 16 MPNST were evaluated. Two radiologists independently assessed the maximum standardized uptake value (SUV_max) and mean and minimum apparent diffusion coefficient (ADC_mean/min) as well as the ADC in areas of lowest signal intensity in each lesion (ADC_dark). The AUCs of DW-MRI and F-18-FDG-PET/CT were compared to determine whether the ADC is non-inferior to SUV_max (non-inferiority margin equal to -10%). Follow-up of ≥ 24 months (BPNST) or histopathological evaluation (MPNST + ANF) served as diagnostic reference standard. Both SUV_max and ADC parameters demonstrated good diagnostic accuracy (AUC_SUVmax 94.0%; AUC_{ADCmean/min/dark} 91.6% / 90.1% / 92.5%). However, non-inferiority could not be demonstrated for any of the three ADC parameters (lower limits of the confidence intervals of the difference between the AUC of ADC_{mean/min/dark} and SUV_max -12.9% / -14.5% / -11.6%). Inter-rater reliability was excellent for both imaging techniques (Krippendorff's alpha all > 0.94).

Conclusions: Both PET/CT-derived SUV_max and MRI-derived ADC allow sensitive and non-invasive differentiation of benign and (pre)-malignant peripheral nerve sheath tumours. Nevertheless, DW-MRI cannot be considered as non-inferior to F-18-FDG-PET/CT in this prospective single-centre study.

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.