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Feng P, Shao Z, Dong B, Fang T, Huang Z, Li Z, Fu F, Wu Y, Wei W, Yuan J, Yang Y, Wang Z, Wang M. Application of diffusion kurtosis imaging and 18F-FDG PET in evaluating the subtype, stage and proliferation status of non-small cell lung cancer. Front Oncol 2022; 12:989131. [PMID: 36248958 PMCID: PMC9562703 DOI: 10.3389/fonc.2022.989131] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background Lung cancer has become one of the deadliest tumors in the world. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for approximately 80%-85% of all lung cancer cases. This study aimed to investigate the value of diffusion kurtosis imaging (DKI), diffusion-weighted imaging (DWI) and 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) in differentiating squamous cell carcinoma (SCC) and adenocarcinoma (AC) and to evaluate the correlation of each parameter with stage and proliferative status Ki-67. Methods Seventy-seven patients with lung lesions were prospectively scanned by hybrid 3.0-T chest 18F-FDG PET/MR. Mean kurtosis (MK), mean diffusivity (MD), apparent diffusion coefficient (ADC), maximum standard uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured. The independent samples t test or Mann–Whitney U test was used to compare and analyze the differences in each parameter of SCC and AC. The diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve analysis and compared with the DeLong test. A logistic regression analysis was used for the evaluation of independent predictors. Bootstrapping (1000 samples) was performed to establish a control model, and calibration curves and ROC curves were used to validate its performance. Pearson’s correlation coefficient and Spearman’s correlation coefficient were calculated for correlation analysis. Results The MK and ADC values of the AC group were significantly higher than those of the SCC group (all P< 0.05), and the SUVmax, MTV, and TLG values of the SCC group were significantly higher than those of the AC group (all P<0.05). There was no significant difference in the MD value between the two groups. Moreover, MK, SUVmax, TLG and MTV were independent predictors of the NSCLC subtype, and the combination of these parameters had an optimal diagnostic efficacy (AUC, 0.876; sensitivity, 86.27%; specificity, 80.77%), which was significantly better than that of MK (AUC = 0.758, z = 2.554, P = 0.011), ADC (AUC = 0.679, z = 2.322, P = 0.020), SUVmax (AUC = 0.740, z = 2.584, P = 0.010), MTV (AUC = 0.715, z = 2.530, P = 0.011) or TLG (AUC = 0.716, z = 2.799, P = 0.005). The ROC curve showed that the validation model had high accuracy in identifying AC and SCC (AUC, 0.844; 95% CI, 0.785-0.885);. The SUVmax value was weakly positively correlated with the Ki-67 index (r = 0.340, P< 0.05), the ADC and MD values were weakly negatively correlated with the Ki-67 index (r = -0.256, -0.282, P< 0.05), and the MTV and TLG values were weakly positively correlated with NSCLC stage (r = 0.342, 0.337, P< 0.05). Conclusion DKI, DWI and 18F-FDG PET are all effective methods for assessing the NSCLC subtype, and some parameters are correlated with stage and proliferation status.
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Affiliation(s)
- Pengyang Feng
- Department of Medical Imaging, Henan University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Zehua Shao
- Heart Center of Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Bai Dong
- Department of Orthopaedics, Henan University People’s Hospital, Zhengzhou, China
| | - Ting Fang
- Department of Medical Imaging, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Zhun Huang
- Department of Medical Imaging, Henan University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Ziqiang Li
- Department of Medical Imaging, Xinxiang Medical University Henan Provincial People’s Hospital, Zhengzhou, China
| | - Fangfang Fu
- Department of Medical Imaging, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yaping Wu
- Department of Medical Imaging, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Wei Wei
- Department of Medical Imaging, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, United Imaging Healthcare Group, Beijing, China
| | - Zhe Wang
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Medical Imaging, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
- *Correspondence: Meiyun Wang,
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Wang L, Lv P, Yang S, Zeng M, Lin J. Assessment of thoracic vasculature in patients with central bronchogenic carcinoma by unenhanced magnetic resonance angiography: comparison between 2D free-breathing TrueFISP, 2D breath-hold TrueFISP and 3D respiratory-triggered SPACE. J Thorac Dis 2017; 9:1624-1633. [PMID: 28740677 DOI: 10.21037/jtd.2017.06.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Preoperative assessment of the integrity of major thoracic vessels in central bronchogenic carcinoma is vital for tumor staging and treatment planning. Contrast-enhanced CT is currently the first choice of modality for this purpose in clinical practice with limitations including exposure to ionizing radiation and the use of iodinated contrast material. MRI has been increasingly employed for the staging of lung cancer. More recently, unenhanced magnetic resonance angiography (MRA) which is totally non-invasive and contrast-free has been reported able to show thoracic vessels. This study was to compare image qualities of three unenhanced-MRAs and to evaluate accuracy of them in assessing thoracic vessel invasion by using contrast-enhanced CT as a reference standard. METHODS A total of 30 patients with central bronchogenic carcinoma confirmed by pathology were examined by CT and unenhanced MRA including 2D free-breathing (FB)-TrueFISP, breath-holding (BH)-TrueFISP and 3D respiratory-triggered (RT)-SPACE. Image qualities of pulmonary arteries and veins, thoracic aorta and vena cava were scored for each MRA sequence. Vessel to lung tissue signal contrast-to-noise ratio (CNR), vessel to tumor signal contrast ratio (VTR), and tumor to background signal contrast ratio (TBR) were calculated. On each method, vessel invasion was evaluated according to types of morphological relationships between the tumor and major vessels. RESULTS The three MRAs showed no significant difference in CNR (P=0.518) while TrueFISP MRAs were better than SPACE in terms of VTR (P=0.000) and image quality (P=0.002). Excellent consistency with CT was found for all three MRAs in assessment of the morphological relationships between tumors and major vessels (FB-TrueFISP: kappa =0.821; BH-TrueFISP: kappa =0.862; RT-SPACE: kappa =0.811). CONCLUSIONS Both TrueFISP and SPACE allow satisfactory visualization of major mediastinal and hilar vessels and are comparable to MDCT in assessment of vessel invasion in patients with central lung cancer. TrueFISP sequences are better than SPACE in regard to image quality and VTR.
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Affiliation(s)
- Lili Wang
- Department of Diagnostic Radiology, Shanghai Zhongshan Hospital, Shanghai Medical College of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Department of Radiology, Xiehe Hospital, Fujian Medical University, Fujian 350001, China
| | - Peng Lv
- Department of Diagnostic Radiology, Shanghai Zhongshan Hospital, Shanghai Medical College of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Shuohui Yang
- Department of Diagnostic Radiology, Shanghai Zhongshan Hospital, Shanghai Medical College of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Mengsu Zeng
- Department of Diagnostic Radiology, Shanghai Zhongshan Hospital, Shanghai Medical College of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Jiang Lin
- Department of Diagnostic Radiology, Shanghai Zhongshan Hospital, Shanghai Medical College of Fudan University and Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Functional and Molecular Medical Imaging of Fudan University, Shanghai 200040, China
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