Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
J Magn Reson Imaging. 2018 Apr;47(4):1013-1021. doi: 10.1002/jmri.25832. Epub 2017 Aug 11.
To compare the capability of amide proton transfer-weighted (APTw) imaging, diffusion-weighted imaging (DWI), and FDG-PET/CT for the differentiation of malignant from benign pulmonary nodules.
In all, 82 consecutive patients with pulmonary nodules underwent APTw imaging and DWI with a 3T system, and FDG-PET/CT. All nodules were divided as either malignant (n = 49) or benign (n = 39) groups based on pathological and follow-up examinations. To evaluate the capability for differentiation of malignant from benign nodules, magnetization transfer ratio asymmetry (MTR )(3.5ppm) on APTw imaging, apparent diffusion coefficient (ADC), and maximum value of standard uptake value (SUV ) were assessed. Receiver operating characteristic (ROC) analyses were performed to computationally determine each feasible threshold value. Next, McNemar's test was used for comparing diagnostic performance with each other as well as with a combination of the significant factors determined by multivariate logistic regression analysis.
Although sensitivity of ADC was significantly higher than that of MTR (3.5 ppm) (P = 0.002) and SUV (P = 0.004), specificity of MTR (3.5 ppm) and SUV was significantly higher than that of ADC (P < 0.05). Sensitivity of combined MTR (3.5ppm) with SUV was significantly higher than that of MTR (3.5ppm) (P = 0.001) and SUV (P = 0.002) alone. Moreover, specificity and accuracy of combined MTR (3.5ppm) with SUV were significantly higher than that of ADC (specificity: P = 0.002, accuracy: P = 0.008).
APTw imaging appears to be as useful as DWI and FDG-PET/CT for differentiation of malignant from benign nodules.
2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1013-1021.
比较酰胺质子转移加权（APTw）成像、扩散加权成像（DWI）和 FDG-PET/CT 对良、恶性肺结节的鉴别能力。
共 82 例连续肺部结节患者行 3T 系统 APTw 成像和 DWI 及 FDG-PET/CT 检查。所有结节均根据病理和随访检查分为恶性（n=49）和良性（n=39）组。为评估鉴别良、恶性结节的能力，评估 APTw 成像上的磁化转移率不对称（MTR）（3.5ppm）、表观扩散系数（ADC）和标准摄取最大值（SUV）。通过计算确定每个可行的阈值，进行受试者工作特征（ROC）分析。然后，使用 McNemar 检验比较各诊断性能与彼此之间的差异，以及与多变量逻辑回归分析确定的显著因素的组合之间的差异。
虽然 ADC 的敏感性明显高于 MTR（3.5ppm）（P=0.002）和 SUV（P=0.004），但 MTR（3.5ppm）和 SUV 的特异性明显高于 ADC（P＜0.05）。联合 MTR（3.5ppm）与 SUV 的敏感性明显高于单独的 MTR（3.5ppm）（P=0.001）和 SUV（P=0.002）。此外，联合 MTR（3.5ppm）与 SUV 的特异性和准确性明显高于 ADC（特异性：P=0.002，准确性：P=0.008）。
APTw 成像在良、恶性结节的鉴别方面似乎与 DWI 和 FDG-PET/CT 一样有用。
2 技术功效：2 级。J. Magn. Reson. Imaging 2018；47：1013-1021。
