Publication: Comparison of diffusion weighted MRI parameters of mediastinal lymph nodes with PET/CT in lung cancer patients
Abstract
Amaç: Akciğer kanserli hastalarda mediastinal lenf nodu tutulumunun değerlendirmesinde difüzyon ağırlıklı manyetik rezonans görüntüleme (DA-MRG) bulguları ile pozitron emisyon tomografisi/bilgisayarlı tomografi (PET/BT) bulguları arasındaki ilişkiyi incelemek. Hastalar ve Yöntem: Tedavi almamış, ardışık 21 akciğer kanserli hasta çalışmaya dahil edildi. DA-MRG 1,5T alan gücüne sahip cihaz ile b 50, 500 ve 1000 değerlerinde yapıldı. Anatomik korelasyon amaçlı ek incelemeler yapıldı. Bulgular: Toplamda 47 lenf nodu değerlendirildi. Lenf nodlarının minimum göreceli difüzyon katsayı (ADCmin) değerleri ile PET/BT de ölçülen maksimum standardize tutulum değerleri (SUVmax) arasında anlamlı ilişki saptanmazken, ADCmin değerlerinin ana kitle ve beyin omurilik sıvısının ADCmin değerlerine oranlandığında elde edilen oranlar ile SUVmax değerleri arasında ilişkili bulundu (sırasıyla r = - 0,407; p = 0,005 ve r = - 0,364 ve p = 0,012). ROC analizi kullanılarak metastaz için eşik değerler belirlendi. Altı lenf nodu histopatolojik olarak değerlendirildi. PET/BT ve DA-MRG bir metastaz pozitif ve iki metastaz negatif lenf nodunu doğru evrelerken, her ikisi de granülomatöz değişiklik barındıran bir lenf nodunda yanlış pozitif sonuç verdi. Histopatolojik olarak metastaz negatif olan iki lenf nodu PET/BTde şüpheli sonuç verirken, DA-MRG bu lenf nodlarını doğru evreledi. Sonuç: DA/MRG, akciğer kanserli hastalarda mediastinal lenf nodlarının değerlendirilmesinde en az PET/BT kadar başarılı olabilir.
Objective: We have compared diffusion-weighted magnetic resonance imaging (DW-MRI) properties of mediastinal lymph nodes in lung cancer patients with positron emission tomography/ computed tomography (PET/CT) findings. Patients and Methods: Twenty-one consecutive untreated patients with lung cancer were included. DW-MRI was performed on a 1,5T scanner with b values of 50, 500 and 1000. Additional MR imaging was performed for anatomical correlation. Results: A total of 47 lymph nodes were analyzed. While no correlation was found between minimum apparent diffusion coefficient (ADC) values (ADCmin) of lymph nodes and their maximum standardized uptake values (SUVmax) on PET/CT, ADCmin ratios of lymph nodes to main lesion (ADCmin Node/ Lesion) (r = - 0.407; p = 0.005) and lymph node to cerebrospinal fluid (ADCmin Node/CSF) (r = - 0.364; p = 0.012) were correlated with SUVmax. Cutoff values for DW-MRI parameters were determined using ROC analysis. Six lymph nodes were histopathologically examined. Both methods correctly identified one metastatic and two metastasis negative lymph nodes, while staging one lymph node with granulomatous change as metastasis positive. Two metastasis negative lymph nodes, reported as suspicious on PET/CT, were correctly staged on DW-MRI. Conclusion: Our findings indicate that DW-MRI could be at least as valuable as PET/CT in mediastinal staging of patients with lung cancer.
Objective: We have compared diffusion-weighted magnetic resonance imaging (DW-MRI) properties of mediastinal lymph nodes in lung cancer patients with positron emission tomography/ computed tomography (PET/CT) findings. Patients and Methods: Twenty-one consecutive untreated patients with lung cancer were included. DW-MRI was performed on a 1,5T scanner with b values of 50, 500 and 1000. Additional MR imaging was performed for anatomical correlation. Results: A total of 47 lymph nodes were analyzed. While no correlation was found between minimum apparent diffusion coefficient (ADC) values (ADCmin) of lymph nodes and their maximum standardized uptake values (SUVmax) on PET/CT, ADCmin ratios of lymph nodes to main lesion (ADCmin Node/ Lesion) (r = - 0.407; p = 0.005) and lymph node to cerebrospinal fluid (ADCmin Node/CSF) (r = - 0.364; p = 0.012) were correlated with SUVmax. Cutoff values for DW-MRI parameters were determined using ROC analysis. Six lymph nodes were histopathologically examined. Both methods correctly identified one metastatic and two metastasis negative lymph nodes, while staging one lymph node with granulomatous change as metastasis positive. Two metastasis negative lymph nodes, reported as suspicious on PET/CT, were correctly staged on DW-MRI. Conclusion: Our findings indicate that DW-MRI could be at least as valuable as PET/CT in mediastinal staging of patients with lung cancer.