Diagnostic Performance of Whole-Body Diffusion-Weighted Imaging Compared to PET-CT Plus Brain MRI in Staging Clinically Resectable Lung Cancer

• Published in: Asian Pacific journal of cancer prevention : APJCP Vol. 17; no. 6; p. 2775
• Main Authors: Usuda, Katsuo, Sagawa, Motoyasu, Maeda, Sumiko, Motono, Nozomu, Tanaka, Makoto, Machida, Yuichiro, Matoba, Takuma Matsui Munetaka, Watanabe, Naoto, Tonami, Hisao, Ueda, Yoshimichi, Uramoto, Hidetaka
• Format: Journal Article
• Language: English
• Published: Thailand 2016
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Carcinoma, Small Cell - diagnosis; Carcinoma, Small Cell - diagnostic imaging; Carcinoma, Small Cell - surgery; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - surgery; Diffusion Magnetic Resonance Imaging - methods; Female; Follow-Up Studies; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - surgery; Male; Middle Aged; Multimodal Imaging - methods; Neoplasm Staging - standards; Positron Emission Tomography Computed Tomography - methods; Prognosis; Whole Body Imaging - methods

Precise staging of lung cancer is usually evaluated by PET-CT and brain MRI. Recently, however, whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) has be applied. The aim of this study is to determine whether the diagnostic performance of lung cancer staging by WB-DWI is superior to that of PET-CT+brain MRI. PET-CT + brain MRI and WB-DWI were used for lung cancer staging before surgery with 59 adenocarcinomas, 16 squamous cell carcinomas and 6 other carcinomas. PET-CT + brain MRI correctly identified the pathologic N staging in 67 patients (82.7%), with overstaging in 5 (6.2%) and understaging in 9 (11.1%), giving a staging accuracy of 0.827. WB-DWI correctly identified the pathologic N staging in 72 patients (88.9%), with overstaging in 1 (1.2%) and understaging in 8 patients (9.9%), giving a staging accuracy of 0.889. There were no significant differences in accuracies. PET-CT + brain MRI correctly identified the pathologic stages in 56 patients (69.1%), with overstaging in 7 (8.6%) and understaging in 18 (22.2%), giving a staging accuracy of 0.691. WB-DWI correctly identified the pathologic stages in 61 patients (75.3%), with overstaging in 4 (4.9%) and understagings in16(19.7%), giving a staging accuracy of 0.753. There were no significant difference in accuracies. Diagnostic efficacy of WB-DWI for lung cancer staging is equivalent to that of PET-CT + brain MRI.