TY - JOUR
T1 - Computed DWI MRI Results in Superior Capability for N-Stage Assessment of Non-Small Cell Lung Cancer Than That of Actual DWI, STIR Imaging, and FDG-PET/CT
AU - Ohno, Yoshiharu
AU - Yui, Masao
AU - Takenaka, Daisuke
AU - Yoshikawa, Takeshi
AU - Koyama, Hisanobu
AU - Kassai, Yoshimori
AU - Yamamoto, Kaori
AU - Oshima, Yuka
AU - Hamabuchi, Nayu
AU - Hanamatsu, Satomu
AU - Obama, Yuki
AU - Ueda, Takahiro
AU - Ikeda, Hirotaka
AU - Hattori, Hidekazu
AU - Murayama, Kazuhiro
AU - Toyama, Hiroshi
N1 - Funding Information:
The authors wish to thank Shinichiro Seki, MD, PhD (Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University School of Medicine), Yuji Kishida, MD, PhD and Takamichi Murakami, MD, PhD (Department of Radiology, Kobe University Graduate School of Medicine), Yugo Tanaka, MD, PhD and Yoshimasa Maniwa, MD, PhD, (Division of General Thoracic Surgery, Kobe University School of Medicine), Naoe Jinbo, MD and Tomoo Ito, MD, PhD (Department of Diagnostic Pathology, Kobe University School of Medicine), and Motoko Tachihara, MD and Yoshihiro Nishimura, MD, PhD (Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine) for their valuable contributions to this study. This work was financially and technically supported by Canon Medical Systems Corporation. Drs. Ohno, Yoshikawa, Murayama and Toyama received a research grant from Canon Medical Systems Corporation, which also supported this work financially and technically.
Publisher Copyright:
© 2022 International Society for Magnetic Resonance in Medicine.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Computed diffusion-weighted imaging (cDWI) is a mathematical computation technique that generates DWIs for any b-value by using actual DWI (aDWI) data with at least two different b-values and may improve differentiation of metastatic from nonmetastatic lymph nodes. Purpose: To determine the appropriate b-value for cDWI to achieve a better diagnostic capability for lymph node staging (N-staging) in non-small cell lung cancer (NSCLC) patients compared to aDWI, short inversion time (TI) inversion recovery (STIR) imaging, or positron emission tomography with 2-[fluorine-18] fluoro-2-deoxy-d-glucose combined with computed tomography (FDG-PET/CT). Study Type: Prospective. Subjects: A total of 245 (127 males and 118 females; mean age 72 years) consecutive histopathologically confirmed NSCLC patients. Field Strength/Sequence: A 3 T, half-Fourier single-shot turbo spin-echo sequence, electrocardiogram (ECG)-triggered STIR fast advanced spin-echo (FASE) sequence with black blood and STIR acquisition and DWI obtained by FASE with b-values of 0 and 1000 sec/mm2. Assessment: From aDWIs with b-values of 0 and 1000 (aDWI1000) sec/mm2, cDWI using 400 (cDWI400), 600 (cDWI600), 800 (cDWI800), and 2000 (cDWI2000) sec/mm2 were generated. Then, 114 metastatic and 114 nonmetastatic nodes (mediastinal and hilar lymph nodes) were selected and evaluated with a contrast ratio (CR) for each cDWI and aDWI, apparent diffusion coefficient (ADC), lymph node-to-muscle ratio (LMR) on STIR, and maximum standard uptake value (SUVmax). Statistical Tests: Receiver operating characteristic curve (ROC) analysis, Youden index, and McNemar's test. Results: Area under the curve (AUC) of CR600 was significantly larger than the CR400, CR800, CR2000, aCR1000, and SUVmax. Comparison of N-staging accuracy showed that CR600 was significantly higher than CR400, CR2000, ADC, aCR1000, and SUVmax, although there were no significant differences with CR800 (P = 0.99) and LMR (P = 0.99). Data Conclusion: cDWI with b-value at 600 sec/mm2 may have potential to improve N-staging accuracy as compared with aDWI, STIR, and PET/CT. Evidence Level: 2. Technical Efficacy: Stage 2.
AB - Background: Computed diffusion-weighted imaging (cDWI) is a mathematical computation technique that generates DWIs for any b-value by using actual DWI (aDWI) data with at least two different b-values and may improve differentiation of metastatic from nonmetastatic lymph nodes. Purpose: To determine the appropriate b-value for cDWI to achieve a better diagnostic capability for lymph node staging (N-staging) in non-small cell lung cancer (NSCLC) patients compared to aDWI, short inversion time (TI) inversion recovery (STIR) imaging, or positron emission tomography with 2-[fluorine-18] fluoro-2-deoxy-d-glucose combined with computed tomography (FDG-PET/CT). Study Type: Prospective. Subjects: A total of 245 (127 males and 118 females; mean age 72 years) consecutive histopathologically confirmed NSCLC patients. Field Strength/Sequence: A 3 T, half-Fourier single-shot turbo spin-echo sequence, electrocardiogram (ECG)-triggered STIR fast advanced spin-echo (FASE) sequence with black blood and STIR acquisition and DWI obtained by FASE with b-values of 0 and 1000 sec/mm2. Assessment: From aDWIs with b-values of 0 and 1000 (aDWI1000) sec/mm2, cDWI using 400 (cDWI400), 600 (cDWI600), 800 (cDWI800), and 2000 (cDWI2000) sec/mm2 were generated. Then, 114 metastatic and 114 nonmetastatic nodes (mediastinal and hilar lymph nodes) were selected and evaluated with a contrast ratio (CR) for each cDWI and aDWI, apparent diffusion coefficient (ADC), lymph node-to-muscle ratio (LMR) on STIR, and maximum standard uptake value (SUVmax). Statistical Tests: Receiver operating characteristic curve (ROC) analysis, Youden index, and McNemar's test. Results: Area under the curve (AUC) of CR600 was significantly larger than the CR400, CR800, CR2000, aCR1000, and SUVmax. Comparison of N-staging accuracy showed that CR600 was significantly higher than CR400, CR2000, ADC, aCR1000, and SUVmax, although there were no significant differences with CR800 (P = 0.99) and LMR (P = 0.99). Data Conclusion: cDWI with b-value at 600 sec/mm2 may have potential to improve N-staging accuracy as compared with aDWI, STIR, and PET/CT. Evidence Level: 2. Technical Efficacy: Stage 2.
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U2 - 10.1002/jmri.28288
DO - 10.1002/jmri.28288
M3 - Article
C2 - 35753082
AN - SCOPUS:85132352812
SN - 1053-1807
VL - 57
SP - 259
EP - 272
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
IS - 1
ER -