Hiroaki Nomori1, Yue Cong2, Hiroshi Sugimura2, Yoshiaki Kato3. 1. Department of General Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan. hnomori@qk9.so-net.ne.jp. 2. Department of General Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan. 3. Diagnostic Radiology, Kameda Medical Center, Chiba, Japan.
Abstract
PURPOSES: To examine whether diffusion-weighted magnetic resonance imaging (DWI) is as useful as fluorodeoxyglucose positron emission tomography (FDG-PET) for discriminating between malignant and benign pulmonary nodules measuring less than 3 cm in size, as well as for predicting tumor aggressiveness. METHODS: PET and DWI were carried out on 87 pulmonary nodules measuring from 1 to 3 cm in size (66 NSCLCs and 21 benign nodules). The signal intensity (SI) of DWI was measured by the contrast ratio (CR) between the lesions and spinal cord, i.e., SI-CR. The maximum standard uptake value (SUV) of PET was measured by CR between the lesions and contralateral lung, i.e., SUV-CR. RESULTS: DWI and PET showed sensitivities of 0.86 and 0.71, and specificities of 0.90 and 0.81, respectively. While there was no significant difference in the specificity between the two, DWI showed a significantly higher sensitivity than PET (p = 0.013). While the difference in the sensitivity was significant in lung adenocarcinoma (p = 0.012), there was no difference in the other histological types. Both the SI-CR and SUV-CR were significantly higher in the tumors with either histological invasiveness or lymphatic metastasis than in those without. CONCLUSIONS: DWI is thus considered to be useful, not only to diagnose NSCLCs, especially in lung adenocarcinoma, but also for predicting tumor aggressiveness as well as FDG-PET.
PURPOSES: To examine whether diffusion-weighted magnetic resonance imaging (DWI) is as useful as fluorodeoxyglucose positron emission tomography (FDG-PET) for discriminating between malignant and benign pulmonary nodules measuring less than 3 cm in size, as well as for predicting tumor aggressiveness. METHODS: PET and DWI were carried out on 87 pulmonary nodules measuring from 1 to 3 cm in size (66 NSCLCs and 21 benign nodules). The signal intensity (SI) of DWI was measured by the contrast ratio (CR) between the lesions and spinal cord, i.e., SI-CR. The maximum standard uptake value (SUV) of PET was measured by CR between the lesions and contralateral lung, i.e., SUV-CR. RESULTS: DWI and PET showed sensitivities of 0.86 and 0.71, and specificities of 0.90 and 0.81, respectively. While there was no significant difference in the specificity between the two, DWI showed a significantly higher sensitivity than PET (p = 0.013). While the difference in the sensitivity was significant in lung adenocarcinoma (p = 0.012), there was no difference in the other histological types. Both the SI-CR and SUV-CR were significantly higher in the tumors with either histological invasiveness or lymphatic metastasis than in those without. CONCLUSIONS: DWI is thus considered to be useful, not only to diagnose NSCLCs, especially in lung adenocarcinoma, but also for predicting tumor aggressiveness as well as FDG-PET.
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