Ohba Yasuomi, Nomori Hiroaki, Mori Takeshi, Ikeda Koei, Shibata Hidekatsu, Kobayashi Hironori, Shiraishi Shinya, Katahira Kazuhiro
Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
J Thorac Cardiovasc Surg. 2009 Aug;138(2):439-45. doi: 10.1016/j.jtcvs.2008.12.026. Epub 2009 Mar 29.
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.
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.
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.
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.
本回顾性分析旨在研究扩散加权磁共振成像是否与氟脱氧葡萄糖F 18正电子发射断层扫描一样，可用于(1)鉴别非小细胞肺癌与良性肺结节，以及(2)预测非小细胞肺癌的侵袭性。
对110例患有124个直径小于3 cm肺结节的患者在手术前进行了扩散加权磁共振成像和正电子发射断层扫描，其中包括96例非小细胞肺癌和28个良性结节。通过表观扩散系数的最小值来测量磁共振成像中水分子的扩散情况。标准对照为组织学诊断结果或随访检查结果。比较了扩散加权成像和正电子发射断层扫描在鉴别癌症与良性结节方面的敏感性和特异性。研究了扩散加权成像中的表观扩散系数和正电子发射断层扫描中的氟脱氧葡萄糖F 18摄取情况与病理肿瘤分期、淋巴、血管和胸膜受累情况以及组织学分化之间的关系。
扩散加权磁共振成像和正电子发射断层扫描在非小细胞肺癌的敏感性或特异性方面无显著差异。正电子发射断层扫描显示，在病理分期IA与IB期或更晚期之间；在有和无淋巴、血管或胸膜受累的肿瘤之间；以及在高分化与中分化或低分化腺癌之间，氟脱氧葡萄糖F 18摄取存在显著差异(P <.01 - 0.001)，但表观扩散系数值未观察到显著差异。
扩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等同于正电子发射断层扫描，但在预测非小细胞肺癌的侵袭性方面不如正电子发射断层扫描有用。
