Department of Radiology, University of Fukui, Fukui, Japan.
J Magn Reson Imaging. 2013 Jul;38(1):80-8. doi: 10.1002/jmri.23959. Epub 2012 Dec 12.
To evaluate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) for assessment of the early response to chemotherapy and outcome in patients with advanced lung cancer through comparison with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT).
Twenty-eight lung cancer patients underwent DW-MRI, FDG-PET, and CT before and after one course of chemotherapy. Changes in the apparent diffusion coefficient (ΔADC), the mean standardized uptake value (ΔSUV), and the maximum diameter (ΔMD) were measured and compared. According to the response evaluation criteria, patients were divided into two groups, responders and nonresponders, and progression-free survival (PFS) and overall survival (OS) were estimated.
The relationship between ΔADC and ΔSUV had the highest correlation coefficient. A cutoff value of ΔADC between responders and nonresponders was estimated as 21.5%. PFS and OS between responders and nonresponders were significantly different on DW-MRI (PFS, P = 0.012; OS, P = 0.006) and on FDG-PET (PFS, P = 0.017; OS, P = 0.036), but not on CT (PFS, P = 0.105; OS, P = 0.051).
DW-MRI can be used to predict prognosis in patients with advanced lung cancer.
通过与氟-18 氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）和计算机断层扫描（CT）比较，评估扩散加权磁共振成像（DW-MRI）在评估晚期肺癌患者化疗早期反应和结局的可行性。
28 例肺癌患者在化疗前和化疗后进行了 DW-MRI、FDG-PET 和 CT 检查。测量并比较了表观扩散系数（ΔADC）、平均标准化摄取值（ΔSUV）和最大直径（ΔMD）的变化。根据反应评估标准，将患者分为反应者和非反应者两组，并估计无进展生存期（PFS）和总生存期（OS）。
ΔADC 与 ΔSUV 之间的相关性最高。将反应者和非反应者之间的 ΔADC 截断值估计为 21.5%。DW-MRI 上反应者和非反应者的 PFS（P = 0.012）和 OS（P = 0.006）以及 FDG-PET 上的 PFS（P = 0.017）和 OS（P = 0.036）差异有统计学意义，但 CT 上无差异（PFS，P = 0.105；OS，P = 0.051）。
DW-MRI 可用于预测晚期肺癌患者的预后。
