DW MRI at 3.0 T versus FDG PET/CT for detection of malignant pulmonary tumors

• Published in: International journal of cancer Vol. 134; no. 3; pp. 606 - 611
• Main Authors: Zhang, Jian, Cui, Long‐Biao, Tang, Xing, Ren, Xin‐Ling, Shi, Jie‐Ran, Yang, Hai‐Nan, Zhang, Yan, Li, Zhi‐Kui, Wu, Chang‐Gui, Jian, Wen, Zhao, Feng, Ti, Xin‐Yu, Yin, Hong
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley-Blackwell 01.02.2014; Wiley Subscription Services, Inc
• Subjects: assessment; Biological and medical sciences; Cancer; Diffusion Magnetic Resonance Imaging - methods; DW MRI; FDG PET/CT; Humans; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - diagnostic imaging; Medical research; Medical sciences; Multimodal Imaging - methods; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); NMR; Nuclear magnetic resonance; Pneumology; Positron-Emission Tomography - methods; ROC Curve; Sensitivity and Specificity; Tomography; Tomography, X-Ray Computed - methods; Tumors; Tumors of the respiratory system and mediastinum; Radionuclide study; Lung disease; 2-deoxy-2-fluoroglucose; Radiodiagnosis; Respiratory disease; Lung cancer; Lung; Malignant tumor; FDG PET/CT; Respiratory system; Nuclear magnetic resonance imaging; assessment; Cancerology; DW MRI; Medical imagery; Bronchus disease; Computerized axial tomography; Diagnosis; Detection; Positron emission tomography; Comparative study; Cancer; Emission tomography; lung cancer
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.28394

Emerging evidence suggests that diffusion‐weighted magnetic resonance imaging (DW MRI) could be useful for tumor detection with N and M staging of lung cancer in place of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). DW MRI at 3.0 T and FDG PET/CT were performed before therapy in 113 patients with pulmonary nodules. Mean apparent diffusion coefficient (ADC), maximal standardized uptake value (SUVmax) and Ki‐67 scores were assessed. Quantitatively, specificity and accuracy of ADC (91.7 and 92.9%, respectively) were significantly higher than those of SUVmax (66.7 and 77.9% respectively, p < 0.05), although sensitivity was not significantly different between them (93.5 and 83.1%, p > 0.05). Qualitatively, sensitivity, specificity and accuracy of DW MRI (96.1, 83.3 and 92.0%, respectively) were also not significantly different from that of FDG PET/CT (88.3, 83.3 and 86.7%, respectively, p > 0.05). Significant negative correlation was found between Ki‐67 score and ADC (r = −0.66, p < 0.05), ADC and SUVmax (r = −0.37, p < 0.05), but not between Ki‐67 score and SUVmax (r = −0.11, p > 0.05). In conclusion, quantitative and qualitative assessments for detection of malignant pulmonary tumors with DW MRI at 3.0 T are superior to those with FDG PET/CT. Furthermore, ADC could predict the malignancy of lung cancer. What's new? The standard noninvasive imaging tool in TNM staging of lung cancer is fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Recent studies, however, have suggested that diffusion‐weighted magnetic resonance imaging (DW MRI) may be as accurate as or better than FDG PET/CT for the detection and evaluation of lung cancer. Here, the diagnostic capability of DW MRI at 3.0 Tesla was found to be superior to that of FDG PET/CT, quantitatively and qualitatively, in the case of malignant pulmonary tumors. In addition, a possible prognostic role was identified for the technique's apparent diffusion coefficient.