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X. Tang



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    O23 - Imaging and Screening (ID 125)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      O23.06 - Diffusion-weighted magnetic resonance imaging at 3.0-T versus fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography for detection of pulmonary malignant tumors (ID 88)

      17:10 - 17:20  |  Author(s): X. Tang

      • Abstract
      • Presentation
      • Slides

      Background
      Emerging evidences suggests that diffusion-weighted magnetic resonance imaging (DW MRI) at 1.5-T could be useful for tumor detection, together with N and M staging in patients with lung cancer, especially non-small cell lung cancer (NSCLC), with accuracy as good as, or even better than, that of FDG PET/CT most recently. This investigation prospectively examined whether DW MRI at 3.0-T might be as useful as FDG PET/CT for detection of pulmonary malignant tumors.

      Methods
      This study was approved by the institutional review board, and written informed consent was obtained from all patients. DW MRI and FDG PET/CT were performed before therapy in 113 patients with pulmonary nodules, including lung cancer, lung metastases, and benign lesions, diagnosed by pathological examination. Apparent diffusion coefficient (ADC), maximal standardized uptake value (SUV~max~), and five-point visual scoring were assessed. Immunohistochemical staining for Ki-67 was performed in 36 patients with lung cancer, and Ki-67 score was evaluated. Receiver operating characteristic (ROC) curve analysis was used to determine feasible threshold values. Diagnostic capabilities for detection of pulmonary malignant tumors were compared with the McNemar test on a per-patient basis, and correlation between malignant degree of lung cancer and ADC or SUV~max~ was analyzed by Spearman rank test.

      Results
      As for diagnostic capability, area under ROC curve (A~z~) for ADC (0.91) were significantly higher than that for SUV~max~ (0.78, P < 0.05), and A~z~ value for DW MRI (0.94) were not significantly different from that for FDG PET/CT (0.92, P > 0.05). For quantitative assessment, specificity and accuracy of ADC (91.7%, 92.9%) proved to be significantly higher than those of SUV~max~ (66.7%, 77.9%, P < 0.05), although sensitivity of ADC (93.5%) was not significantly different from that of SUV~max~ (83.1%, P > 0.05). When feasible threshold values were used to assess qualitatively, sensitivity, specificity, and accuracy of DW MRI (96.1%, 83.3%, 92.0%) were also not significantly different from that of FDG PET/CT (88.3%, 83.3%, 86.7%, P > 0.05). Significant correlation was found between Ki-67 score and ADC (Spearman coefficient r = -0.66, P < 0.05), as well as ADC and SUV~max~ (r = -0.37, P < 0.05). On the contrary, Spearman coefficient was -0.11 between Ki-67 score and SUV~max~ (P > 0.05).

      Conclusion
      In conclusion, quantitative and qualitative assessments for detection of pulmonary malignant tumors obtained with DW MRI at 3.0-T are as useful as, even superior to, those obtained with FDG PET/CT. Furthermore, another significant outcome of this study was that ADC in DW MRI at 3.0-T can also play a role in prediction for malignant degree of lung cancer in particular, but SUV~max~ did not in FDG PET/CT.

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