Impact of FDG-PET and Dynamic Contrast-Enhanced MRI in Comparison with DWI for N-Staging in Lung Cancer Patients (CHEST IMAGING)

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Flechsig Paul; Zabeck Heike; Reubold Sebastian; SachpekidiS Christos; Rathke Hendrik; ROhrich Manuel; Holland Letz Tim; Heussel Claus Peter; Harms Alexander; Kauczor Hans Ulrich; Haberkorn Uwe; Giesel Frederik L.

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Journal: Iranian Journal of Radiology Year:2019 | Volume:16 | Issue:1 Page(s): 0-0

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Title

Impact of FDG-PET and Dynamic Contrast-Enhanced MRI in Comparison with DWI for N-Staging in Lung Cancer Patients (CHEST IMAGING)

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Keywords

Lung Cancer

staging

FDG-PET/CT

Magnetic Resonance Imaging

DWI

Abstract

Background: 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. Objectives: 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. Patients and Methods: 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. Results: 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 1528mm2/s was found to exclude malignancy for LNs that are above the threshold. Conclusion: 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.

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APA: Copy

Flechsig, Paul, Zabeck, Heike, Reubold, Sebastian, SachpekidiS, Christos, Rathke, Hendrik, ROhrich, Manuel, Holland Letz, Tim, Heussel, Claus Peter, Harms, Alexander, & Kauczor, Hans Ulrich. (2019). Impact of FDG-PET and Dynamic Contrast-Enhanced MRI in Comparison with DWI for N-Staging in Lung Cancer Patients (CHEST IMAGING). IRANIAN JOURNAL OF RADIOLOGY, 16(1), 0-0. SID. https://sid.ir/paper/284490/en

Vancouver: Copy

Flechsig Paul, Zabeck Heike, Reubold Sebastian, SachpekidiS Christos, Rathke Hendrik, ROhrich Manuel, Holland Letz Tim, Heussel Claus Peter, Harms Alexander, Kauczor Hans Ulrich. Impact of FDG-PET and Dynamic Contrast-Enhanced MRI in Comparison with DWI for N-Staging in Lung Cancer Patients (CHEST IMAGING). IRANIAN JOURNAL OF RADIOLOGY[Internet]. 2019;16(1):0-0. Available from: https://sid.ir/paper/284490/en

IEEE: Copy

Paul Flechsig, Heike Zabeck, Sebastian Reubold, Christos SachpekidiS, Hendrik Rathke, Manuel ROhrich, Tim Holland Letz, Claus Peter Heussel, Alexander Harms, and Hans Ulrich Kauczor, “Impact of FDG-PET and Dynamic Contrast-Enhanced MRI in Comparison with DWI for N-Staging in Lung Cancer Patients (CHEST IMAGING),” IRANIAN JOURNAL OF RADIOLOGY, vol. 16, no. 1, pp. 0–0, 2019, [Online]. Available: https://sid.ir/paper/284490/en

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