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N stage disease in patients with non-small cell lung cancer: efficacy of quantitative and qualitative assessment with STIR turbo spin-echo imaging, diffusion-weighted MR imaging, and fluorodeoxyglucose PET/CT
- Source :
- Radiology. 261(2)
- Publication Year :
- 2011
-
Abstract
- To prospectively compare the diagnostic capability of short inversion time inversion-recovery (STIR) turbo spin-echo (SE) imaging, diffusion-weighted (DW) magnetic resonance (MR) imaging, and fluorodeoxyglucose (FDG) combined positron emission tomography (PET) and computed tomography (CT) in N stage assessment in patients with non-small cell lung cancer (NSCLC).This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. A total of 250 consecutive patients with NSCLC (136 men; mean age, 73 years; 114 women; mean age, 72 years) prospectively underwent pretherapeutic STIR turbo SE imaging, DW MR imaging, and FDG PET/CT, as well as surgical and pathologic examinations (N0 disease, n = 157; N1 disease, n = 72; N2 disease, n = 16; N3 disease, n = 5). Lymph node-to-saline ratio (LSR), lymph node-to-muscle ratio (LMR), apparent diffusion coefficient (ADC), maximal standardized uptake value (SUV(max)), and visual scoring were assessed for 135 metastatic lymph nodes and 135 randomly selected nonmetastatic lymph nodes. Receiver operating characteristic curve analysis was used to determine feasible threshold values. Diagnostic capabilities for N stage assessment were compared with the McNemar test on a per-patient basis.When feasible, threshold values were used for quantitative assessment; sensitivity and accuracy of LSR and LMR (sensitivity, 82.8%; accuracy, 86.8%) proved to be significantly higher than those of ADC (sensitivity: 74.2%, P = .01; accuracy: 84.4%, P = .04) and SUV(max) (sensitivity: 74.2%, P = .01). For qualitative assessment, sensitivity of STIR turbo SE imaging (77.4%) was significantly higher than that of DW MR imaging (71.0%, P = .03) and FDG PET/CT (69.9%, P = .02).Quantitative and qualitative assessments of N stage disease in patients with NSCLC obtained with STIR turbo SE MR imaging are more sensitive and/or more accurate than those obtained with DW MR imaging and FDG PET/CT.http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110281/-/DC1.
- Subjects :
- Male
medicine.medical_specialty
Lung Neoplasms
Inversion Time
Multimodal Imaging
Sensitivity and Specificity
Fluorodeoxyglucose PET
Fluorodeoxyglucose F18
Carcinoma, Non-Small-Cell Lung
Medicine
Humans
Radiology, Nuclear Medicine and imaging
In patient
Prospective Studies
Diffusion-Weighted MR Imaging
Lung cancer
Aged
Neoplasm Staging
business.industry
Fast spin echo
medicine.disease
Mr imaging
Magnetic Resonance Imaging
Diffusion Magnetic Resonance Imaging
Positron-Emission Tomography
Female
Non small cell
Radiology
Radiopharmaceuticals
business
Nuclear medicine
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 15271315
- Volume :
- 261
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Radiology
- Accession number :
- edsair.doi.dedup.....c6c0a0577cdfc1c19a89eccbad34db8c