Is diffusion-weighted magnetic resonance imaging superior to positron emission tomography with fludeoxyglucose F 18 in imaging non-small cell lung cancer?
Is diffusion-weighted magnetic resonance imaging superior to positron emission tomography with fludeoxyglucose F 18 in imaging non-small cell lung cancer?
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DOI：
10.1016/j.jtcvs.2008.12.026
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发表时间：
2009-08-01
影响因子：
6
通讯作者：
Katahira, Kazuhiro
中科院分区：
文献类型：
--
作者：
Ohba, Yasuomi;Nomori, Hiroaki;Katahira, Kazuhiro
目的：探讨磁共振弥散加权成像在鉴别非小细胞肺癌与良性肺结节及预测非小细胞肺癌侵袭性方面与正电子发射断层扫描的价值。方法：对110例124个直径小于3 cm的肺结节患者术前行磁共振弥散加权成像和正电子发射断层扫描，其中非小细胞肺癌96例，良性结节28例。用表观扩散系数最小值测量水分子在磁共振成像中的扩散。以组织学诊断或随访检查结果为标准。比较扩散加权成像和正电子发射断层扫描在区分肿瘤和良性结节方面的敏感性和特异性。结果：磁共振弥散加权成像和正电子发射断层扫描对非小细胞肺癌的敏感性和特异性无显著差异。而正电子发射断层扫描显示病理IA期与IB期或更晚期之间，肿瘤有无淋巴管、血管或胸膜受累，以及高分化腺癌与中低分化腺癌之间的氟脱氧葡萄糖F18摄取有显著差异(P<；.01-0.001)。结论：弥散加权磁共振成像在鉴别非小细胞肺癌与良性肺结节方面与正电子发射断层扫描相当，但不能作为预测非小细胞肺癌侵袭性的有用指标。
Objective: This retrospective analysis examined whether diffusion-weighted magnetic resonance imaging might be as useful as positron emission tomography with fludeoxyglucose F 18 for (1) discriminating between non-small cell lung cancer and benign pulmonary nodules and (2) predicting aggressiveness of non-small cell lung cancer.Methods: Diffusion-weighted magnetic resonance imaging and positron emission tomography were performed before surgery in 110 patients with 124 pulmonary nodules smaller than 3 cm, including 96 non-small cell lung cancers and 28 benign nodules. Diffusion of water molecules in magnetic resonance imaging was measured by minimum value of apparent diffusion coefficient. The criterion standard was the result of histologic diagnosis or follow-up examination. Sensitivity and specificity for differentiating between cancers and benign nodules were compared between diffusion-weighted imaging and positron emission tomography. Apparent diffusion coefficient in diffusion-weighted imaging and fludeoxyglucose F 18 uptake in positron emission tomography were examined with respect to pathologic tumor stage; lymphatic, vascular and pleural involvements; and histologic differentiation.Results: There were no significant differences between diffusion-weighted magnetic resonance imaging and positron emission tomography in sensitivity or specificity for non-small cell lung cancer. Whereas positron emission tomography showed significant differences in fludeoxyglucose F 18 uptake between pathologic stages IA versus IB or more advanced stages; between tumors with and without lymphatic, vascular, or pleural involvement; and between well-differentiated and moderately or poorly differentiated adenocarcinomas (P < .01-0.001), no significant differences in apparent diffusion coefficient values in were observed.Conclusion: Diffusion-weighted magnetic resonance imaging is equivalent to positron emission tomography in distinguishing non-small cell lung cancer from benign pulmonary nodules but is not as useful for predicting aggressiveness of non-small cell lung cancer.