Usuda Katsuo, Funazaki Aika, Maeda Ryo, Sekimura Atsushi, Motono Nozomu, Matoba Munetaka, Uramoto Hidetaka
Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan.
Department of Radiology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan.
Ann Thorac Cardiovasc Surg. 2017 Dec 20;23(6):275-280. doi: 10.5761/atcs.ra.17-00097. Epub 2017 Oct 4.
This paper focuses on the latest research of diffusion-weighted magnetic resonance imaging (DWI), and deals with economic benefits, diagnostic benefits, and prospects of DWI for lung cancer. The medical cost of a magnetic resonance imaging (MRI) is 81%-84% cheaper than that of 18-fluoro-2-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT). DWI is reported to be useful for differential diagnosis of malignancy or benignity for neoplasm in various organs. Diagnostic efficacy by DWI for pulmonary nodules and masses and the evaluation of N factor and M factor in lung cancer are equivalent to or more than that of FDG-PET/CT. The diagnostic capability of whole-body DWI (WB-DWI) for the staging of clinically operable lung cancers is equivalent to that of FDG-PET/CT and brain MRI, and WB-DWI is now becoming a more main stream procedure. Although the diagnostic performance of DWI for lung cancer may be equivalent to that of FDG-PET/CT, prospective randomized controlled trial for comparison of diagnostic efficacy between FDG-PET/CT and DWI for lung cancer is necessary for an accurate comparison. DWI may have an advantage in the aspect of the cost and diagnostic efficacy in lung cancer management.
本文聚焦于磁共振扩散加权成像(DWI)的最新研究,探讨了DWI在肺癌方面的经济效益、诊断效益及前景。磁共振成像(MRI)的医疗成本比18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET/CT)便宜81%-84%。据报道,DWI有助于对各器官肿瘤的良恶性进行鉴别诊断。DWI对肺结节和肿块的诊断效能以及对肺癌N因子和M因子的评估等同于或优于FDG-PET/CT。全身DWI(WB-DWI)对临床可手术肺癌分期的诊断能力等同于FDG-PET/CT和脑部MRI,且WB-DWI正成为一种更主流的检查方法。尽管DWI对肺癌的诊断性能可能等同于FDG-PET/CT,但为了进行准确比较,有必要开展前瞻性随机对照试验来比较FDG-PET/CT和DWI对肺癌的诊断效能。DWI在肺癌管理的成本和诊断效能方面可能具有优势。