Impact of FDG-PET and dynamic contrast-enhanced MRI in comparison with DWI for N-staging in lung cancer patients

• Verfasst von: Flechsig, Paul [VerfasserIn]
• Verfasst von: Zabeck, Heike [VerfasserIn]
• Verfasst von: Reubold, Sebastian [VerfasserIn]
• Verfasst von: Sachpekidis, Christos [VerfasserIn]
• Verfasst von: Rathke, Hendrik [VerfasserIn]
• Verfasst von: Röhrich, Manuel [VerfasserIn]
• Verfasst von: Heußel, Claus Peter [VerfasserIn]
• Verfasst von: Harms, Alexander [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Haberkorn, Uwe [VerfasserIn]
• Verfasst von: Giesel, Frederik L. [VerfasserIn]
• Titel: Impact of FDG-PET and dynamic contrast-enhanced MRI in comparison with DWI for N-staging in lung cancer patients
• Verf.angabe: Paul Flechsig, Heike Zabeck, Sebastian Reubold, Christos Sachpekidis, Hendrik Rathke, Manuel Röhrich, Tim Holland-Letz, Claus-Peter Heussel, Alexander Harms, Hans-Ulrich Kauczor, Uwe Haberkorn, and Frederik L. Giesel
• Jahr: 2019
• Jahr des Originals: 2018
• Fussnoten: Accepted 2018 September 03 ; Gesehen am 15.07.2019
• Titel Quelle: Enthalten in: Iranian journal of radiology
• Ort Quelle: Tehran : TUMS Publications, 2003
• Jahr Quelle: 2019
• Band/Heft Quelle: 19(2019,1) Artikel-Nummer e68638, 10 Seiten
• ISSN Quelle: 2008-2711
• DOI: doi:10.5812/iranjradiol.68638
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1669194485

Abstract

Regarding mediastinal N-staging in lung cancer patients, computed tomography (CT), magnetic resonance imaging (MRI), and integrated 18Fluorine-fluorodeoxyglucose-positron emission tomography/CT (18F-FDG-PET/CT) are the most widespread imaging methodologies in clinical routine.In order to further extract information from non-invasive staging, we evaluated the use of 18F-FDG-PET/CT and dynamic contrast enhanced (DCE) and diffusion-weighted imaging (DWI) MRI using histopathology as the diagnostic gold standard. A total number of 50 patients had undergone MRI of the chest within two weeks prior to surgery for histopathological proof. DCE-MRI was evaluated on the basis of region of interest (ROI)-based signal intensity/time (SI/T) curves in the respective mediastinal lymph nodes (LNs). In total, 28 LNs could be allocated to the corresponding histopathological findings, as well as to corresponding findings in 18F-FDG-PET/CT.Malignant LNs presented with significantly higher FDG uptake in PET. Significant differences between malignant and benign LNs were found for DCE-MRI regarding the parameters MaxE, 4-minutes value, SE, EP and EP/MaxE. In DWI-MRI, malignant LNs presented with significantly lower signal intensity compared to benign LNs (p < 0.01). An apparent diffusion coefficient (ADC) threshold of 1528 mm2/s was found to exclude malignancy for LNs that are above the threshold.18F-FDG-PET in addition with MRI that includes DWI might improve mediastinal N-staging, which is of interest in cases of FDG-equivocal LNs. An ADC threshold of 1528 mm2/s might potentially help to further classify LNs with indefinite PET-findings. DCE-MRI of mediastinal LNs seems not yet to be approved for clinical routine.