Department of Medical Imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.
Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China.
J Magn Reson Imaging. 2022 Oct;56(4):1118-1129. doi: 10.1002/jmri.28135. Epub 2022 Mar 8.
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.
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).
Prospective.
A total of 99 patients with lung cancer.
FIELD STRENGTH/SEQUENCE: APTWI and DWI at F-FDG PET/MRI 3.0 T.
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.
Individual sample t-test, Mann-Whitney U test, Logistic regression, and P < 0.05 were considered statistically significant.
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.
In the noninvasive assessment of lung cancer subtype and EGFR status, APTWI has similar utility to diffusion and metabolic parameters.
2 TECHNICAL EFFICACY STAGE: 2.
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。
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。
前瞻性。
共 99 例肺癌患者。
磁场强度/序列： F-FDG PET/MRI 3.0T 上的 APTWI 和 DWI。
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）。
个体样本 t 检验、Mann-Whitney U 检验、Logistic 回归，P<0.05 为统计学显著。
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。
在肺癌亚型和 EGFR 状态的非侵入性评估中，APTWI 与弥散和代谢参数具有相似的效用。
2 技术功效阶段：2。
