Differentiation between suture recurrence and suture granuloma after pulmonary resection for lung cancer by diffusion-weighted magnetic resonance imaging or FDG-PET / CT

Katsuo Usuda; Shun Iwai; Aika Yamagata; Yoshihito Iijima; Nozomu Motono; Munetaka Matoba; Mariko Doai; Sohsuke Yamada; Yoshimichi Ueda; Keiya Hirata; Hidetaka Uramoto

doi:10.1016/j.tranon.2020.100992

Differentiation between suture recurrence and suture granuloma after pulmonary resection for lung cancer by diffusion-weighted magnetic resonance imaging or FDG-PET / CT

Transl Oncol. 2021 Feb;14(2):100992. doi: 10.1016/j.tranon.2020.100992. Epub 2020 Dec 15.

Authors

Affiliations

¹ Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan. Electronic address: usuda@kanazawa-med.ac.jp.
² Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan.
³ Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan.
⁴ Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan.
⁵ Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan.
⁶ MRI Center, Kanazawa Medical University Hospital, Uchinada, Ishikawa, 920-0293 Japan.

Abstract

There has been no publication which supports the usefulness of DWI differentiating for suture recurrence and suture granuloma after resection for lung cancer. We presented efficacy of DWI or FDG-PET/CT for an assessment of suture lesions after resection for lung cancer. Thirteen suture recurrences and 15 suture granulomas were examined. There were 24 adenocarcinomas and 4 squamous cell carcinomas, and 26 partial resections and 2 segmentectomies. The period of time (907±907 days) between surgery and suture recurrence was not significantly longer than that (546±547 days) between surgery and suture granuloma. Diffusion detectability scores (a 5-point scale) of suture recurrences was significantly higher than that of suture granulomas. The ADC value (1.35±0.24 × 10^-3mm²/sec) of suture recurrences was significantly lower than that (1.85±0.60 × 10^-3mm²/sec) of suture granulomas. The SUVmax (6.1 ± 5.0) of suture recurrences was not significantly higher than that (4.2 ± 2.5) of suture granulmas. The sensitivity of 85% (11/13) with DWI was not significantly higher than 69% (9/13) with FDG-PET/CT for suture recurrences. The specificity of 73% (11/15) with DWI was not significantly higher than the 60% (9/15) with FDG-PET/CT for suture granulomas. The accuracy of 79% (22/28) with DWI was not significantly higher than that of 64% (18/28) with FDG-PET/CT for suture recurrences and granulomas. DWI can differentiate suture granuloma from suture recurrence after resection of lung cancer. DWI is more useful than FDG-PET/CT for the differentiation between suture recurrence and suture granuloma after resection for lung cancer.

Keywords: 18-fluoro-2-deoxy-glucose positron emission tomography / computed tomography (FDG-PET/CT); Apparent diffusion coefficient (ADC); Diffusion-weighted magnetic resonance imaging (DWI); Lung cancer; Magnetic resonance imaging (MRI); Suture granuloma; Suture recurrence.