酰胺质子转移加权成像对肺癌亚型和表皮生长因子受体的评估：与扩散和代谢参数的对比研究。

Evaluation of Amide Proton Transfer-Weighted Imaging for Lung Cancer Subtype and Epidermal Growth Factor Receptor: A Comparative Study With Diffusion and Metabolic Parameters.

机构信息

Department of Medical Imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.

Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China.

出版信息

J Magn Reson Imaging. 2022 Oct;56(4):1118-1129. doi: 10.1002/jmri.28135. Epub 2022 Mar 8.

DOI:10.1002/jmri.28135

PMID:35258145

Abstract

BACKGROUND

Lung cancer is one of the most devastating diseases worldwide, and it is meaningful to assess the subtype and epidermal growth factor receptor (EGFR) status in lung cancer noninvasively by imaging methods.

PURPOSE

To differentiate noninvasively small cell lung cancer (SCLC) from nonsmall cell lung cancer (NSCLC), and EGFR mutation-type from wild-type NSCLC by comparing amide proton transfer-weighted imaging (APTWI), diffusion-weighted imaging (DWI), and 2-[ F]-fluoro-2-deoxy-d-glucose positron emission tomography ( F-FDG PET).

STUDY TYPE

Prospective.

POPULATION

A total of 99 patients with lung cancer.

FIELD STRENGTH/SEQUENCE: APTWI and DWI at F-FDG PET/MRI 3.0 T.

ASSESSMENT

The apparent diffusion coefficient (ADC), magnetization transfer ratio asymmetry (MTRasym [3.5 ppm]), maximum standardized uptake value (SUV ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated and compared.

STATISTICAL TESTS

Individual sample t-test, Mann-Whitney U test, Logistic regression, and P < 0.05 were considered statistically significant.

RESULTS

In NSCLC, MTRasym (3.5 ppm), MTV, and TLG were significantly lower and ADC was significantly higher than in SCLC; MTRasym (3.5 ppm) was significantly higher and SUV , MTV, and TLG were significantly lower in EGFR mutation-type NSCLC than in EGFR wild-type NSCLC. In the identification of SCLC and NSCLC, MTRasym (3.5 ppm), ADC, and MTV were independent predictors, the AUCs of the combination of independent predictors, MTV, TLG, MTRasym (3.5 ppm), and ADC were 0.942, 0.875, 0.843, 0.814, and 0.687, respectively. In the identification of EGFR mutation-type and wild-type NSCLC, MTRasym (3.5 ppm) and MTV were independent predictors, the AUCs of the combination of independent predictors, TLG, MTV, MTRasym (3.5 ppm), and SUV were 0.919, 0.834, 0.813, 0.795, and 0.771, respectively.

DATA CONCLUSION

In the noninvasive assessment of lung cancer subtype and EGFR status, APTWI has similar utility to diffusion and metabolic parameters.

LEVEL OF EVIDENCE

2 TECHNICAL EFFICACY STAGE: 2.

摘要

背景

肺癌是全球最具破坏性的疾病之一，通过影像学方法非侵入性地评估肺癌的亚型和表皮生长因子受体（EGFR）状态具有重要意义。

目的

通过比较酰胺质子转移加权成像（APTWI）、弥散加权成像（DWI）和 2-[F]-氟-2-脱氧-D-葡萄糖正电子发射断层扫描（ F-FDG PET），区分小细胞肺癌（SCLC）和非小细胞肺癌（NSCLC），以及 EGFR 突变型与野生型 NSCLC。

研究类型

前瞻性。

人群

共 99 例肺癌患者。

磁场强度/序列： F-FDG PET/MRI 3.0T 上的 APTWI 和 DWI。

评估

计算并比较表观弥散系数（ADC）、磁化转移率不对称（MTRasym[3.5ppm]）、最大标准化摄取值（SUV）、代谢肿瘤体积（MTV）和总肿瘤糖酵解（TLG）。

统计检验

个体样本 t 检验、Mann-Whitney U 检验、Logistic 回归，P<0.05 为统计学显著。

结果

在 NSCLC 中，MTRasym（3.5ppm）、MTV 和 TLG 明显低于 SCLC，ADC 明显高于 SCLC；MTRasym（3.5ppm）明显高于 EGFR 突变型 NSCLC，SUV、MTV 和 TLG 明显低于 EGFR 野生型 NSCLC。在 SCLC 和 NSCLC 的鉴别中，MTRasym（3.5ppm）、ADC 和 MTV 是独立的预测因子，独立预测因子的组合、MTV、TLG、MTRasym（3.5ppm）和 ADC 的 AUC 分别为 0.942、0.875、0.843、0.814 和 0.687。在 EGFR 突变型和野生型 NSCLC 的鉴别中，MTRasym（3.5ppm）和 MTV 是独立的预测因子，独立预测因子的组合、TLG、MTV、MTRasym（3.5ppm）和 SUV 的 AUC 分别为 0.919、0.834、0.813、0.795 和 0.771。