Department of Thoracic Surgery, Tokyo Medical University, Japan.
Lung Cancer. 2010 Aug;69(2):203-8. doi: 10.1016/j.lungcan.2009.10.016. Epub 2009 Nov 27.
To evaluate the hypothesis that lung cancer treatment planning (whether or not to use induction therapy) can be improved if respiratory dynamic cine magnetic resonance imaging (RD MR) is used.
We studied 100 lung cancer patients, 76 men and 21 women, scheduled for thoracotomies between May 1997 and December 2006 wherein it was unclear preoperatively whether chest wall invasion would be found. We evaluated the accuracy of RD MR as compared with the findings at operation and postoperative pathology. The accuracy of RD MRI for evaluating chest wall invasion was compared with the efficacy of CT and MRI within our own group of patients and with data from the studies of other investigators.
Concerning the evaluation of chest wall invasion, conventional computed tomography (CT) had 43.9% specificity, 60.0% sensitivity and 47.1% accuracy, while RD MR had 68.5% specificity, 100.0% sensitivity and 77.0% accuracy. RD MRI was particularly useful in the evaluation of cancers around 5 cm in diameter that were located adjacent to the diaphragm. Postoperative evaluation of superior sulcus tumor cases that had received induction therapy also showed that the RD MR procedure enabled an accurate decision in 87.5% of cases, and there were no false negative cases.
RD MR is more useful than CT or standard MRI for evaluating thoracic wall invasion. This noninvasive method enhances the reliability of deciding whether induction therapy should be employed.
评估假设，即如果使用呼吸动态电影磁共振成像（RD MR），肺癌治疗计划（是否使用诱导治疗）可以得到改善。
我们研究了 100 例肺癌患者，76 名男性和 21 名女性，计划在 1997 年 5 月至 2006 年 12 月间进行开胸手术，术前尚不清楚是否会发现胸壁侵犯。我们评估了 RD MR 的准确性，与手术和术后病理结果进行了比较。将 RD MRI 评估胸壁侵犯的准确性与我们自己的患者组中 CT 和 MRI 的疗效以及其他研究者的数据进行了比较。
在评估胸壁侵犯方面，常规计算机断层扫描（CT）的特异性为 43.9%，敏感性为 60.0%，准确性为 47.1%，而 RD MR 的特异性为 68.5%，敏感性为 100.0%，准确性为 77.0%。RD MRI 在评估直径约 5 厘米且位于膈肌附近的癌症方面特别有用。接受诱导治疗的上沟肿瘤病例的术后评估还表明，RD MR 程序在 87.5%的病例中能够做出准确的决策，且无假阴性病例。
RD MR 比 CT 或标准 MRI 更有助于评估胸壁侵犯。这种非侵入性方法提高了决定是否采用诱导治疗的可靠性。
