European journal of radiology · 2026
Whole-body MRI versus fluorodeoxyglucose PET/CT for extra-nodal metastatic staging in lung adenocarcinoma.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Khoda Jeevitesh, Niranjanamurthy Likhith, Gupta Manoj, Puri Sunil Kumar, Goyal Jitin, Chandra Aditi, Lingegowda Dayananda, Mukhopadhyay Sumit, Sen Saugata
Аннотация
OBJECTIVES: To evaluate the diagnostic accuracy and cost-effectiveness of whole-body magnetic resonance imaging (WB-MRI) versus 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for detecting extra-nodal metastatic lesions in lung adenocarcinoma.
MATERIALS AND METHODS: This prospective single-centre study enrolled 70 patients with biopsy-proven lung adenocarcinoma who underwent FDG-PET/CT and WB-MRI (3 T) for initial staging; one patient was excluded (mucinous adenocarcinoma). The final cohort comprised 69 patients (mean age 55.8 ± 13.1 years, 46 men): 40 with metastatic disease and 29 without (true negatives). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and inter-modality agreement were calculated at lesion level against histopathology or six-month follow-up imaging. Paired comparisons used McNemar's test.
RESULTS: Sixty-nine patients (mean age 55.8 ± 13.1 years, 46 men) were evaluated. WB-MRI detected 278 lesions versus 260 for FDG-PET/CT. WB-MRI achieved sensitivity of 95.10 % (95 % CI: 91.95-97.06 %), specificity of 95.57 % (95 % confidence interval (CI): 92.42-97.45 %), and accuracy of 95.33 % (95 % CI: 93.25-96.79 %). FDG-PET/CT achieved sensitivity of 91.85 % (95 % CI: 87.97-94.56 %), specificity of 95.65 % (95 % CI: 92.56-97.50 %), and accuracy of 93.77 % (95 % CI: 91.42-95.51 %). WB-MRI sensitivity was significantly higher than FDG-PET/CT (McNemar's test, p < 0.001); specificity was equivalent (p = 0.074). Inter-modality agreement was almost perfect (κ = 0.91). WB-MRI cost 148 Euro (16,000 Indian Rupee [INR]) per patient versus 442 Euro (48,000 INR) for FDG-PET/CT.
CONCLUSION: WB-MRI demonstrates diagnostic accuracy equivalent to FDG-PET/CT for extra-nodal metastatic staging in lung adenocarcinoma, with the additional advantages of no ionising radiation and substantially lower cost.
MATERIALS AND METHODS: This prospective single-centre study enrolled 70 patients with biopsy-proven lung adenocarcinoma who underwent FDG-PET/CT and WB-MRI (3 T) for initial staging; one patient was excluded (mucinous adenocarcinoma). The final cohort comprised 69 patients (mean age 55.8 ± 13.1 years, 46 men): 40 with metastatic disease and 29 without (true negatives). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and inter-modality agreement were calculated at lesion level against histopathology or six-month follow-up imaging. Paired comparisons used McNemar's test.
RESULTS: Sixty-nine patients (mean age 55.8 ± 13.1 years, 46 men) were evaluated. WB-MRI detected 278 lesions versus 260 for FDG-PET/CT. WB-MRI achieved sensitivity of 95.10 % (95 % CI: 91.95-97.06 %), specificity of 95.57 % (95 % confidence interval (CI): 92.42-97.45 %), and accuracy of 95.33 % (95 % CI: 93.25-96.79 %). FDG-PET/CT achieved sensitivity of 91.85 % (95 % CI: 87.97-94.56 %), specificity of 95.65 % (95 % CI: 92.56-97.50 %), and accuracy of 93.77 % (95 % CI: 91.42-95.51 %). WB-MRI sensitivity was significantly higher than FDG-PET/CT (McNemar's test, p < 0.001); specificity was equivalent (p = 0.074). Inter-modality agreement was almost perfect (κ = 0.91). WB-MRI cost 148 Euro (16,000 Indian Rupee [INR]) per patient versus 442 Euro (48,000 INR) for FDG-PET/CT.
CONCLUSION: WB-MRI demonstrates diagnostic accuracy equivalent to FDG-PET/CT for extra-nodal metastatic staging in lung adenocarcinoma, with the additional advantages of no ionising radiation and substantially lower cost.
Предметные рубрики MeSH
HumansMaleFluorodeoxyglucose F18Lung NeoplasmsPositron Emission Tomography Computed TomographySensitivity and SpecificityMiddle AgedMagnetic Resonance ImagingWhole Body ImagingRadiopharmaceuticalsAdenocarcinomaFemaleNeoplasm StagingReproducibility of ResultsLymphatic MetastasisAdenocarcinoma of LungProspective StudiesAged