Data from: Pulmonary nodule detection in patients with a primary malignancy using hybrid PET/MRI: is there value in adding contrast-enhanced MR imaging?

Purpose: To investigate the added value of post-contrast VIBE (volumetric-interpolated breath-hold examination) to PET/MR imaging for pulmonary nodule detection in patients with primary malignancies. Materials and Methods: This retrospective institutional review board–approved study, with waiver of informed consent, included 51 consecutive patients who underwent 18F-fluorodeoxyglucose (FDG) PET/MR followed by PET/CT for cancer staging. In all patients, the thorax was examined with pre-and post-contrast VIBE MR with simultaneous PET acquisition. Two readers blinded to the patients’ data independently recorded their level of suspicion for pulmonary nodules based on PET, pre-contrast VIBE, and fused PET/MR images (first session), and reassessed them 4-weeks later after addition of post-contrast VIBE (second session). Jackknife alternative free-response receiver-operating-characteristic (JAFROC) analysis was performed, with PET/CT as the reference standard. Results: A total of 151 pulmonary nodules (44 FDG-avid, 107 non-FDG-avid nodules) were detected on PET/CT, including 62 nodules≥5mm in diameter and 89 nodules<5mm. In the first session, the average nodule detection rate was 53.3% for all nodules, 97.7% for FDG-avid, 35.0% for non-FDG-avid nodules, 87.9% for nodules≥5mm and 29.2% for nodules<5mm. In the second session, the average detection rate was 53.3% for all nodules, 97.7% for FDG-avid, 35.0% for non-FDG-avid nodules, 85.5% for nodules≥5mm and 30.9% for nodules<5mm. The average JAFROC figure-of-merit was 0.837 in the first session and 0.848 in the second session. There were no significant differences in detection performance between sessions (P=0.48). Conclusion: The addition of post-contrast VIBE to hybrid PET/MR imaging provided no additional value in the detection of pulmonary nodules.研究目的：探讨对比剂增强后容积插值屏息成像（volumetric-interpolated breath-hold examination, VIBE）附加于PET/MR成像时，对原发性恶性肿瘤患者肺结节检测的附加价值。 材料与方法：本研究为经机构审查委员会批准的回顾性研究，且豁免知情同意。共纳入51例连续入组患者，所有患者均先接受18F-氟代脱氧葡萄糖（18F-fluorodeoxyglucose, FDG）PET/MR检查，随后行PET/CT检查以进行癌症分期。所有患者均接受了对比剂注射前后的VIBE MR成像，并同步进行PET采集。两名对患者信息不知情的阅片者，分别基于PET图像、对比前VIBE图像以及融合PET/MR图像（第一阶段）独立记录其对肺结节的怀疑程度；并在加入对比后VIBE图像后的4周重新进行评估（第二阶段）。以PET/CT作为参考标准，进行折刀替代自由响应受试者工作特征（Jackknife alternative free-response receiver-operating-characteristic, JAFROC）分析。 结果：PET/CT共检出151个肺结节，其中44个为FDG高摄取结节，107个为非FDG高摄取结节；包含62个直径≥5mm的结节与89个直径<5mm的结节。第一阶段中，所有肺结节的平均检出率为53.3%，FDG高摄取结节为97.7%，非FDG高摄取结节为35.0%，直径≥5mm结节为87.9%，直径<5mm结节为29.2%。第二阶段中，所有肺结节的平均检出率为53.3%，FDG高摄取结节为97.7%，非FDG高摄取结节为35.0%，直径≥5mm结节为85.5%，直径<5mm结节为30.9%。第一阶段的平均JAFROC品质因数为0.837，第二阶段为0.848。两阶段的检测性能无显著差异（P=0.48）。 结论：在一体化PET/MR成像中添加对比剂增强后VIBE序列，并未为肺结节检测带来额外价值。