Role of diffusion-weighted magnetic resonance imaging for predicting of tumor invasiveness for clinical stage IA non-small cell lung cancer
Role of diffusion-weighted magnetic resonance imaging for predicting of tumor invasiveness for clinical stage IA non-small cell lung cancer
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DOI：
10.1016/j.ejcts.2008.12.039
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发表时间：
2009-04-01
影响因子：
3.4
通讯作者：
Sadahiro, Mitsuaki
中科院分区：
文献类型：
--
作者：
Kanauchi, Naoki;Oizumi, Hiroyuki;Sadahiro, Mitsuaki
目的：最近，全身弥散加权磁共振成像(DWI)已经可以用于临床，就像以前用于中枢神经系统的那样。已有报道使用该成像系统区分某些器官的良恶性病变，并与肺癌的细胞分化程度相关联。本研究的目的是评估弥散加权成像在预测非小细胞肺癌(NSCLC)尤其是临床IA期患者肿瘤侵袭力方面的作用。方法：2006年1月至2007年9月，对41例临床分期为IA的非小细胞肺癌患者行术前弥散加权成像和18F-FDG-PET/CT检查。表现为结节、淋巴管或胸膜侵犯的肺癌被定义为浸润性肺癌。弥散加权成像显示脊髓内有强暗信号的结节定义为弥散加权成像阳性。我们分析了术前临床因素：年龄、性别、吸烟史、术前CEA水平(=5.0 ng/ml)、术前肿瘤大小、PET/CT的SUV max(5.0)和DWI(阳性或阴性)与病理结果的关系。结果：共有15个病灶(37%)为DWI阳性，26个(63%)为阴性。单因素分析显示，浸润性癌的发生与术前癌胚抗原水平(p=0.049)、最大摄氧量(p=0.001)和弥散系数(p<；0.001)呈正相关。多因素分析显示弥散系数(p=0.005)是肿瘤侵袭性的独立预测因素。结论：弥散加权成像可作为临床IA期非小细胞肺癌侵袭性预测的有用方法。(C)2009年欧洲胸颈外科协会。爱思唯尔出版，版权所有。
Objectives: Recently, diffusion-weighted MR imaging (DWI) for the whole body has become available for clinical use, as has been previously used for the central nervous system. Favorable results have been reported using this imaging system to differentiate between benign and malignant lesions in some organs, and to correlate with the degree of cell differentiation in lung cancer. The purpose of this study was to assess the rote of DWI for predicting tumor invasiveness of non-small cell lung cancers (NSCLC), especially for clinical stage IA patients. Methods: From January 2006 to September 2007, preoperative DWI and 18F-FDG-PET/CT were performed on 41 patients with clinical stage IA NSCLC who had undergone curative operations. Lung cancers that exhibited nodal, lymphovascular or pleural invasion were defined as invasive lung cancers. Nodules with strong dark signal, as observed by DWI in spinal cords, were defined as DWI-positive. We analyzed the associations between the pathological findings and the following preoperative clinical factors: age, gender, smoking history, preoperative CEA levels (= 5.0 ng/ml), preoperative tumor size, SUV max on PET/CT (5.0) and DWI (positive or negative). Results: A total of 15 lesions (37%) were assessed as DWI-positive and 26 lesions (63%) were DWI-negative. Univariate analyses showed positive correlations for development of invasive cancer with the preoperative CEA level (p = 0.049), SUV max (p = 0.001) and DWI (p < 0.001). Multivariate analysis showed that DWI (p = 0.005) was an independent predictive factor for tumor invasiveness. Conclusion: Our results suggest that DWI might be a useful method for predicting tumor invasiveness for clinical stage IA NSCLC. (C) 2009 European Association for Carcho-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.