在评估磁共振成像在神经内分泌肿瘤的非肝转移诊断准确性方面，与参考标准生长抑素受体正电子发射计算机断层扫描相比较。
Evaluation of MRI in the diagnostic accuracy of extrahepatic metastases in neuroendocrine tumors in comparison with the reference standard somatostatin-receptor-PET/CT.
发表日期：2023
作者：
Maria Ingenerf, Johannes Rübenthaler, Vera Wenter, Mathias Zacherl, Friederike Völter, Michael Winkelmann, Homeira Karim, Regina Schinner, Jens Ricke, Frank Berger, Christine Schmid-Tannwald
来源：
Bone & Joint Journal
摘要：
本研究的目的是比较不同磁共振（MR）序列组合在常规肝磁共振成像（MRI）中检测NETs的肝外病变的诊断效能。通过回顾分析了127例接受肝MR和SSTR-PET/CT检查的NETs患者（有无肝转移和肝外转移）。两名放射科医生在四个会诊中评估了淋巴结、骨骼、腹膜表面、肺底和腹部器官的转移（1.非对比T1w+T2w（NC），2.NC+DWI，3.NC+造影增强T1w（CE），4.NC+DWI+CE）。以患者为单位计算了每个会诊的敏感性、特异性、阳性和阴性预测值，以确诊转移的存在和数量；以病灶为单位分析了检测率和错误率。通过McNemar检验将MR会诊与正电子发射断层扫描-计算机断层扫描（PET/CT）进行比较。
和PET/CT检测到的1094个病灶相比，NC+DWI和NC分别检测到了最多的真阳性病灶，分别为779个（71%）和775个（71%）。以患者为单位的分析显示，NC+DWI的敏感性（85%）显著高于NC和NC+CE（p = 0.011和0.004）；NC+CE+DWI的特异性最高（100%）。以病灶为单位的分析显示，NC+DWI和NC、CE+DWI对淋巴结转移的检出率最高分别为73%和76%；NC和CE+DWI的误检率为5%，低于NC+DWI的17%。对于骨转移，NC+DWI和NC、CE+DWI的检出率相似（分别为75%和74%），而CE并未显示出优势。对于腹膜转移，NC+DWI的敏感性最高（67%）。
NC+DWI的组合显示出比NC+CE的更好的敏感性。与NC+CE+DWI相比，NC+DWI的敏感性相似，甚至更好，但特异性较低。
Copyright © 2023 Ingenerf, Rübenthaler, Wenter, Zacherl, Völter, Winkelmann, Karim, Schinner, Ricke, Berger and Schmid-Tannwald.
The aim of this study was to compare the diagnostic performance of different sets of MR sequences in detecting extrahepatic disease of NETs on routine liver magnetic resonance imaging (MRI).One hundred twenty-seven patients with NETs with and without hepatic and extrahepatic metastases who underwent liver MRI and SSTR-PET/CT were retrospectively analyzed. Two radiologists evaluated in consensus in four sessions: (1) non-contrast T1w+T2w (NC), (2) NC+DWI, (3) NC+ contrast-enhanced T1w (CE), and (4) NC+DWI+CE the presence and number of metastases (lymph nodes, bone, peritoneal surface, lung base, and abdominal organ). Sensitivity, specificity, positive, and negative predictive value for detection of metastases were calculated for each session in a patient-based manner; detection and error rates were calculated for lesion-based analysis. Comparison between the MR-sessions and positron emission tomography-computed tomography (PET/CT) was performed with the McNemar test.Regarding all 1,094 lesions detected in PET/CT, NC+DWI, and NC, CE+DWI identified most true-positive lesions 779 (71%) and 775 (71%), respectively. Patient-based analysis revealed significantly higher sensitivity by NC+DWI (85%) than NC and NC+CE (p = 0.011 and 0.004, respectively); the highest specificity was reached by NC+CE+DWI (100%). Site-based analysis revealed highest detection rates for lymph node metastases for NC+DWI and NC, CE+DWI (73 and 76%, respectively); error rates were lower for NC, CE+DWI with 5% compared with 17% (NC+DWI). Detection rates for bone metastases were similarly high in NC+DWI and NC, CE+DWI (75 and 74%, respectively), while CE showed no benefit. For peritoneal metastases highest sensitivity was reached by NC+DWI (67%).The combination of NC+DWI showed better sensitivities than the combination of NC+CE. NC+DWI showed similar, sometimes even better sensitivities than NC+CE+DWI, but with lower specificities.Copyright © 2023 Ingenerf, Rübenthaler, Wenter, Zacherl, Völter, Winkelmann, Karim, Schinner, Ricke, Berger and Schmid-Tannwald.