TEP-TDM au FNa et IRM avec séquences de diffusion dans la détection des métastases osseuses : étude comparative prospective par lésion

Introduction. - The development of technologies aimed to detect bone metastases in nuclear medicine and radiology prompts us to compare their performance in their most effective form: positron emission tomography (PET) with NaF combined with computed tomography (CT) and magnetic resonance imaging (MRI) using anatomical and diffusion weighted sequences (T1-STIR, and DWI MRI), as well as to study several factors involved in the visualization of these lesions (anatomo-functional correlation, nature, size and localization). Materials and methods. - Thirteen patients underwent NaF PET-CT and T1-STIR-DWI MRI in a prospective study. One hundred and sixty-four lesions were found. For each, a malignancy score of 1 to 5 was assigned. Expert consensus and follow-up data for each patient, available in their medical records, determined the final diagnosis as gold standard. Results. - The sensitivities, specificities, precision and AUC of the lesion-based analysis were respectively 78.3%, 93.8%, 89.3% and 0.85 for NaF PET-CT and 60.9%, 97.4%, 86.7% and 0.81 for T1-STIR-DWI MRI. Results were independent on the nature, size or location of the metastases. A significant change in AUC when CT was combined with PET, and when DWI was combined with T1-STIR was found for one of the two observers in both fields. Conclusion. - The performance of PET-CT at NaF and T1-STIR-DWI MRI appeared equivalent. The combination of functional and morphological images is beneficial in both fields (nuclear and magnetic resonance) but its contribution varies depending on the observer. (C) 2021 Elsevier Masson SAS. All rights reserved.