Diagnostic Performance of Whole-Body Diffusion-Weighted Imaging Compared to PET-CT Plus Brain MRI in Staging Clinically Resectable Lung Cancer

Asian Pac J Cancer Prev. 2016;17(6):2775-80.

Abstract

Background: Precise staging of lung cancer is usually evaluated by PET-CT and brain MRI. Recently, however, whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) has be applied. The aim of this study is to determine whether the diagnostic performance of lung cancer staging by WB-DWI is superior to that of PET-CT+brain MRI.

Materials and methods: PET-CT + brain MRI and WB-DWI were used for lung cancer staging before surgery with 59 adenocarcinomas, 16 squamous cell carcinomas and 6 other carcinomas.

Results: PET-CT + brain MRI correctly identified the pathologic N staging in 67 patients (82.7%), with overstaging in 5 (6.2%) and understaging in 9 (11.1%), giving a staging accuracy of 0.827. WB-DWI correctly identified the pathologic N staging in 72 patients (88.9%), with overstaging in 1 (1.2%) and understaging in 8 patients (9.9%), giving a staging accuracy of 0.889. There were no significant differences in accuracies. PET-CT + brain MRI correctly identified the pathologic stages in 56 patients (69.1%), with overstaging in 7 (8.6%) and understaging in 18 (22.2%), giving a staging accuracy of 0.691. WB-DWI correctly identified the pathologic stages in 61 patients (75.3%), with overstaging in 4 (4.9%) and understagings in16(19.7%), giving a staging accuracy of 0.753. There were no significant difference in accuracies.

Conclusions: Diagnostic efficacy of WB-DWI for lung cancer staging is equivalent to that of PET-CT + brain MRI.

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Small Cell / diagnosis
  • Carcinoma, Small Cell / diagnostic imaging
  • Carcinoma, Small Cell / surgery
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / surgery
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Neoplasm Staging / standards*
  • Positron Emission Tomography Computed Tomography / methods*
  • Prognosis
  • Whole Body Imaging / methods*