Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031, Basel, Switzerland.
Eur Radiol. 2012 Dec;22(12):2859-67. doi: 10.1007/s00330-012-2542-y. Epub 2012 Jul 9.
To investigate the diagnostic value of whole-body magnetic resonance imaging (MRI) including diffusion-weighted imaging with background signal suppression (DWIBS) for preoperative assessment of non-small-cell lung cancer (NSCLC) in comparison to (18)F-fluorodeoxyglucose (18)FDG) positron emission tomography/computed tomography (PET/CT).
Thirty-three patients with suspected NSCLC were enrolled. Patients were examined before surgery with PET/CT and whole-body MRI including T1-weighted turbo spin echo (TSE), T2-weighted short tau inversion recovery (STIR) and DWIBS sequences (b = 0/800). Histological or cytological specimens were taken as standard of reference.
Whole-body MRI with DWIBS as well as PET/CT provided diagnostic image quality in all cases. Sensitivity for primary tumour detection: MRI 93%, PET/CT 98%. T-staging accuracy: MRI 63%, PET/CT 56%. N-staging accuracy: MRI 66%, PET/CT 71%. UICC staging accuracy: MRI 66%, PET/CT 74%. Sensitivity for metastatic involvement of individual lymph node groups: MRI 44%, PET/CT 47%. Specificity for individual non-metastatic lymph node groups: MRI 93%, PET/CT 96%. Assessment accuracy for individual lymph node groups: MRI 85%, PET/CT 88%. Observer agreement rate for UICC staging: MRI 74%, PET/CT 90%.
Whole-body MRI with DWIBS provides comparable results to PET/CT in staging of NSCLC, but shows no superiority. Most relevant challenges for both techniques are T-staging accuracy and sensitivity for metastatic lymph node involvement.
Numerous radiological methods are available for the crucial staging of lung cancer. Whole-body DWIBS MRI provides comparable results to PET/CT in NSCLC staging. No evident superiority of whole-body DWIBS over PET/CT in NSCLC staging. Challenges for both techniques are T-staging and detection of small metastases.
与（18）氟-脱氧葡萄糖（18）FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）相比，研究全身磁共振成像（MRI）包括背景信号抑制弥散加权成像（DWIBS）对非小细胞肺癌（NSCLC）术前评估的诊断价值。
共纳入 33 例疑似 NSCLC 患者。患者术前接受 PET/CT 和全身 MRI 检查，包括 T1 加权涡轮自旋回波（TSE）、T2 加权短 tau 反转恢复（STIR）和 DWIBS 序列（b = 0/800）。以组织学或细胞学标本为标准。
全身 MRI 加 DWIBS 及 PET/CT 均能提供诊断性图像质量。对原发性肿瘤检测的敏感性：MRI 为 93%，PET/CT 为 98%。T 分期准确性：MRI 为 63%，PET/CT 为 56%。N 分期准确性：MRI 为 66%，PET/CT 为 71%。UICC 分期准确性：MRI 为 66%，PET/CT 为 74%。对各淋巴结组转移受累的敏感性：MRI 为 44%，PET/CT 为 47%。对各非转移性淋巴结组的特异性：MRI 为 93%，PET/CT 为 96%。对各淋巴结组的评估准确性：MRI 为 85%，PET/CT 为 88%。UICC 分期观察者间一致性：MRI 为 74%，PET/CT 为 90%。
全身 DWIBS MRI 在 NSCLC 分期中与 PET/CT 结果相当，但无明显优势。这两种技术最相关的挑战是 T 分期准确性和对转移性淋巴结受累的敏感性。
有许多影像学方法可用于肺癌的关键分期。全身 DWIBS MRI 在 NSCLC 分期中与 PET/CT 结果相当。全身 DWIBS 与 PET/CT 相比，在 NSCLC 分期中无明显优势。这两种技术的挑战都是 T 分期和小转移灶的检测。
