Clinical impact of PET/MRI in oligometastatic colorectal cancer
Menée à partir de données portant sur 31 patients atteints d'un cancer colorectal (âge médian : 53 ans ; 52 % d'hommes), cette étude analyse, par rapport aux examens standard d'imagerie, l'intérêt d'un système d'imagerie couplant une tomographie numérique par émission de positrons et une IRM pour détecter avec précision des oligométastases
Background : Oligometastatic colorectal cancer (CRC) is potentially curable and demands individualised strategies.
Methods : This single-centre retrospective study investigated if positron emission tomography (PET)/magnetic resonance imaging (MR) had a clinical impact on oligometastatic CRC relative to the standard of care imaging (SCI). Adult patients with oligometastatic CRC on SCI who also underwent PET/MR between 3/2016 and 3/2019 were included. The exclusion criterion was lack of confirmatory standard of reference, either surgical pathology, intraoperative gross confirmation or imaging follow-up. SCI consisted of contrast-enhanced (CE) computed tomography (CT) of the chest/abdomen/pelvis, abdominal/pelvic CE-MR, and/or CE whole-body PET/CT with diagnostic quality (i.e. standard radiation dose) CT. Follow-up was evaluated until 3/2020.
Results : Thirty-one patients constituted the cohort, 16 (52%) male, median patient age was 53 years (interquartile range: 49–65 years). PET/MR and SCI results were divergent in 19% (95% CI 9–37%) of the cases, with PET/MR leading to management changes in all of them. The diagnostic accuracy of PET/MR was 90 ± 5%, versus 71 ± 8% for SCI. In a pairwise analysis, PET/MR outperformed SCI when compared to the reference standard (p = 0.0412).
Conclusions : These findings suggest the potential usefulness of PET/MR in the management of oligometastatic CRC.
British Journal of Cancer , résumé, 2021