Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan.
Department of Radiology, Kanazawa Medical University, Kahoku-gun, Japan.
Thorac Cancer. 2021 Mar;12(5):676-684. doi: 10.1111/1759-7714.13820. Epub 2021 Jan 21.
Diffusion-weighted whole-body imaging with background suppression (DWIBS) is used for the diagnosis and staging of cancers. The medical cost of an MR examination including DWIBS is $123, which is 80% less expensive than the cost ($798) of F18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) examination.
This study examined the efficacy of DWIBS for relapses after lung cancer resection. A total of 55 patients who had pulmonary resection of lung cancer, postoperative computed tomography (CT) every six months, and DWIBS and FDG-PET/CT (every year) were enrolled in this study. If a metastatic lesion was detected on CT scan, DWIBS and FDG-PET/CT were also used.
A total of 55 patients who underwent pulmonary resections for lung cancer, and had CT, DWIBS and FDG-PET/CT examination during follow-up after pulmonary resection were enrolled in this study. Lung cancer in 32 patients relapsed. Postoperative radiographic examinations revealed pulmonary metastases in 17 patients, bone metastases in seven, liver metastases in five, lymph node metastases in five, pleural metastases in four, metastases to the chest wall in two, brain metastases in two, adrenal gland metastasis in one, and renal metastasis in one. The mean apparent diffusion coefficient (ADC) value of the relapse was 0.9 to 1.70 × 10 mm /s. The accuracy 0.98 (54/55) of DWIBS for detecting multiple metastatic lesions was likely to be higher than 0.94 (52/55) of CT or 0.94 (52/55) of FDG-PET/CT, but there were no significant differences.
DWIBS can detect multiple metastatic lesions throughout the entire body and differentiate malignancy from benignity in only one examination. DWIBS has benefits of diagnostic accuracy and is less expensive in medical costs for the detection of a relapse. DWIBS could potentially replace FDG-PET/CT after lung cancer resection.
全身弥散加权成像（DWIBS）联合背景抑制技术可用于癌症的诊断和分期。与 F18-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）检查（每次 798 美元）相比，MR 检查（包括 DWIBS）的医疗费用仅为其 80%（每次 123 美元）。
本研究评估了 DWIBS 对肺癌切除术后复发的诊断效能。本研究共纳入 55 例行肺癌切除术、术后每 6 个月行 CT 检查、每年行 DWIBS 和 FDG-PET/CT 检查的患者。如果 CT 扫描发现转移病灶，则加做 DWIBS 和 FDG-PET/CT 检查。
本研究共纳入 55 例行肺癌切除术、术后每 6 个月行 CT 检查、每年行 DWIBS 和 FDG-PET/CT 检查的患者。术后共有 32 例患者复发。术后影像学检查显示，17 例患者出现肺部转移，7 例患者出现骨转移，5 例患者出现肝转移，5 例患者出现淋巴结转移，4 例患者出现胸膜转移，2 例患者出现胸壁转移，2 例患者出现脑转移，1 例患者出现肾上腺转移，1 例患者出现肾转移。复发灶的平均表观弥散系数（ADC）值为 0.9 至 1.70×10-3mm2/s。DWIBS 检测多种转移病灶的准确率为 0.98（54/55），可能高于 CT（0.94，52/55）或 FDG-PET/CT（0.94，52/55），但差异无统计学意义。
DWIBS 仅通过一次检查即可检测到全身多个转移病灶，并可鉴别良恶性。DWIBS 在诊断准确性和医疗费用方面具有优势，可用于检测肺癌术后复发。DWIBS 可能会取代肺癌切除术后的 FDG-PET/CT。
