Diffusion-weighted imaging vs STIR turbo SE imaging: capability for quantitative differentiation of small-cell lung cancer from non-small-cell lung cancer
Diffusion-weighted imaging vs STIR turbo SE imaging: capability for quantitative differentiation of small-cell lung cancer from non-small-cell lung cancer
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DOI：
10.1259/bjr.20130307
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发表时间：
2014-06-01
影响因子：
2.6
通讯作者：
Sugimura, K.
中科院分区：
文献类型：
--
作者：
Koyama, H.;Ohno, Y.;Sugimura, K.
目的：比较扩散加权成像(DWI)和短tau反转恢复(STIR)快速自旋回波(STIR)快速自旋回波成像对小细胞肺癌(SCLC)和非小细胞肺癌(NSCLC)的鉴别诊断能力。49例非小细胞肺癌患者(男30例，女19例，平均年龄66.8岁)和7例小细胞肺癌患者(男5例，女2例，平均年龄68.6岁)接受了DWI和STIR检查。为了定量鉴别小细胞肺癌和非小细胞肺癌，我们评估了在DWI上的表观扩散系数(ADC)值和STIR上肿瘤与肌肉的对比度(CRS)。用M ann-Whitney‘s U检验比较两种细胞的ADC值和CRs，用McNemar’s检验比较两种细胞的诊断性能。结果：两种细胞的平均ADC值(p<；0.001)和平均CRs(p=0.003)有显著差异。以所采用的阈值为标准，弥散加权成像的特异度(85.7%)和准确度(85.7%)均高于STIR(特异度63.3%；p=0.001；准确度66.1%；p=0.001)。结论：与STIR相比，DWI对小细胞肺癌与非小细胞肺癌的鉴别诊断更有价值，两者联合应用可显著提高诊断的准确性。
Objective: To compare the capability of differentiation of small-cell lung cancer (SCLC) from non-SCLC (NSCLC) between diffusion-weighted imaging (DWI) and short tau inversion recovery (STIR) turbo spin-echo imaging.Methods: The institutional review board of Kobe University Hospital, Kobe, Japan, approved this study, and written informed consent was obtained from each patient. 49 patients with NSCLC (30 males and 19 females; mean age, 66.8 years) and 7 patients with SCLC (5 males and 2 females; mean age, 68.6 years) enrolled and underwent DWI and STIR. To quantitatively differentiate SCLC from NSCLC, apparent diffusion coefficient (ADC) values on DWI and contrast ratios (CRs) between cancer and muscle on STIR were evaluated. ADC values and CRs were then compared between the two cell types by Mann-Whitney's U-tests, and the diagnostic performances were compared by McNemar's test.Results: There were significant differences of mean ADC values (p < 0.001) and mean CRs (p = 0.003). With adopted threshold values, the specificity (85.7%) and accuracy (85.7%) of DWI were higher than those of STIR (specificity, 63.3%; p = 0.001 and accuracy, 66.1%; p = 0.001). In addition, the accuracy of combination of both indexes (94.6%; p = 0.04) could significantly improve as compared with DWI alone.Conclusion: DWI is more useful for the differentiation of SCLC from NSCLC than STIR, and their combination can significantly improve the accuracy in this setting.Advances in knowledge: Pulmonary MRI, including DWI and STIR, had a potential of the suggestion of the possibility as SCLC.