TY - JOUR
T1 - Amide proton transfer-weighted imaging to differentiate malignant from benign pulmonary lesions
T2 - Comparison with diffusion-weighted imaging and FDG-PET/CT
AU - Ohno, Yoshiharu
AU - Kishida, Yuji
AU - Seki, Shinichiro
AU - Yui, Masao
AU - Miyazaki, Mitsue
AU - Koyama, Hisanobu
AU - Yoshikawa, Takeshi
N1 - Funding Information:
This prospective study was approved by the Institutional Review Board of Kobe University Hospital and written informed consent was obtained from all patients. It was financially and/or technically supported by Toshiba Medical Systems Corporation and Toshiba Medical Research Institute USA. Two of the authors (M.Y. and M.M.) are employees of Toshiba, but did not have control over any of the data and information submitted for publication or which data and information were to be included in this study. All data in this study were managed by four chest radiologists (Y.O., Y.K., S.S., and H.K.) at their respective clinics in Kobe University Hospital.
Funding Information:
Contract grant sponsor: Toshiba Medical Systems Corporation; contract grant number: BN55401050 The authors thank Wakiko Tani, RT, Noriyuki Negi, RT, Kat-susuke Kyotani, RT, Satoru Takahashi, MD, PhD (all from the Center for Radiology and Radiation Oncology, Kobe University Hospital), Motoko Tachihara, MD, Daisuke Tamura, MD, PhD, Kazuyuki Kobayashi, MD, PhD, Yoshihiro Nishi-mura, MD, PhD (all fromthe Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine), Daisuke Hokka, MD, PhD, Yugo Tanaka, MD, PhD, Yoshimasa Maniwa, MD, PhD (all from the Division of Thoracic Surgery, Kobe University Graduate School of Medicine), Yasuhiro Sakai, MD, PhD, and Tomoo Ito, MD, PhD (both from Department of Diagnostic Pathology, Kobe University Graduate School of Medicine) for their valuable contributions to this study.
Publisher Copyright:
© 2017 International Society for Magnetic Resonance in Medicine
PY - 2018/4
Y1 - 2018/4
N2 - Purpose: To compare the capability of amide proton transfer-weighted (APTw) imaging, diffusion-weighted imaging (DWI), and FDG-PET/CT for the differentiation of malignant from benign pulmonary nodules. Materials and Methods: In all, 82 consecutive patients with pulmonary nodules underwent APTw imaging and DWI with a 3T system, and FDG-PET/CT. All nodules were divided as either malignant (n = 49) or benign (n = 39) groups based on pathological and follow-up examinations. To evaluate the capability for differentiation of malignant from benign nodules, magnetization transfer ratio asymmetry (MTR asym )(3.5ppm) on APTw imaging, apparent diffusion coefficient (ADC), and maximum value of standard uptake value (SUV max ) were assessed. Receiver operating characteristic (ROC) analyses were performed to computationally determine each feasible threshold value. Next, McNemar's test was used for comparing diagnostic performance with each other as well as with a combination of the significant factors determined by multivariate logistic regression analysis. Results: Although sensitivity of ADC was significantly higher than that of MTR asym (3.5 ppm) (P = 0.002) and SUV max (P = 0.004), specificity of MTR asym (3.5 ppm) and SUV max was significantly higher than that of ADC (P < 0.05). Sensitivity of combined MTR asym (3.5ppm) with SUV max was significantly higher than that of MTR asym (3.5ppm) (P = 0.001) and SUV max (P = 0.002) alone. Moreover, specificity and accuracy of combined MTR asym (3.5ppm) with SUV max were significantly higher than that of ADC (specificity: P = 0.002, accuracy: P = 0.008). Conclusion: APTw imaging appears to be as useful as DWI and FDG-PET/CT for differentiation of malignant from benign nodules. Level of Evidence: 2. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2018;47:1013–1021.
AB - Purpose: To compare the capability of amide proton transfer-weighted (APTw) imaging, diffusion-weighted imaging (DWI), and FDG-PET/CT for the differentiation of malignant from benign pulmonary nodules. Materials and Methods: In all, 82 consecutive patients with pulmonary nodules underwent APTw imaging and DWI with a 3T system, and FDG-PET/CT. All nodules were divided as either malignant (n = 49) or benign (n = 39) groups based on pathological and follow-up examinations. To evaluate the capability for differentiation of malignant from benign nodules, magnetization transfer ratio asymmetry (MTR asym )(3.5ppm) on APTw imaging, apparent diffusion coefficient (ADC), and maximum value of standard uptake value (SUV max ) were assessed. Receiver operating characteristic (ROC) analyses were performed to computationally determine each feasible threshold value. Next, McNemar's test was used for comparing diagnostic performance with each other as well as with a combination of the significant factors determined by multivariate logistic regression analysis. Results: Although sensitivity of ADC was significantly higher than that of MTR asym (3.5 ppm) (P = 0.002) and SUV max (P = 0.004), specificity of MTR asym (3.5 ppm) and SUV max was significantly higher than that of ADC (P < 0.05). Sensitivity of combined MTR asym (3.5ppm) with SUV max was significantly higher than that of MTR asym (3.5ppm) (P = 0.001) and SUV max (P = 0.002) alone. Moreover, specificity and accuracy of combined MTR asym (3.5ppm) with SUV max were significantly higher than that of ADC (specificity: P = 0.002, accuracy: P = 0.008). Conclusion: APTw imaging appears to be as useful as DWI and FDG-PET/CT for differentiation of malignant from benign nodules. Level of Evidence: 2. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2018;47:1013–1021.
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U2 - 10.1002/jmri.25832
DO - 10.1002/jmri.25832
M3 - Article
C2 - 28799280
AN - SCOPUS:85043599680
SN - 1053-1807
VL - 47
SP - 1013
EP - 1021
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
IS - 4
ER -