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Preoperative staging of non-small-cell lung cancer: comparison of whole-body diffusion-weighted magnetic resonance imaging and 18F-fluorodeoxyglucose-positron emission tomography/computed tomography

Sommer, Gregor ; Wiese, Mark ; Winter, Leopold ; Lenz, Claudia ; Klarhöfer, Markus ; Forrer, Flavio ; Lardinois, Didier ; Bremerich, Jens

In: European Radiology, 2012, vol. 22, no. 12, p. 2859-2867

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    Title
    • Preoperative staging of non-small-cell lung cancer: comparison of whole-body diffusion-weighted magnetic resonance imaging and 18F-fluorodeoxyglucose-positron emission tomography/computed tomography
    Author
    • Sommer, Gregor. Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031, Basel, Switzerland
    • Wiese, Mark. Clinic of Thoracic Surgery, University of Basel Hospital, Spitalstrasse 21, 4031, Basel, Switzerland
    • Winter, Leopold. Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031, Basel, Switzerland
    • Lenz, Claudia. Division of Radiological Physics, Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031, Basel, Switzerland
    • Klarhöfer, Markus. Division of Radiological Physics, Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031, Basel, Switzerland
    • Forrer, Flavio. Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031, Basel, Switzerland
    • Lardinois, Didier. Clinic of Thoracic Surgery, University of Basel Hospital, Spitalstrasse 21, 4031, Basel, Switzerland
    • Bremerich, Jens. Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031, Basel, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:315859
    Summary
    Objective: To investigate the diagnostic value of whole-body magnetic resonance imaging (MRI) including diffusion-weighted imaging with background signal suppression (DWIBS) for preoperative assessment of non-small-cell lung cancer (NSCLC) in comparison to 18F-fluorodeoxyglucose 18FDG) positron emission tomography/computed tomography (PET/CT). Methods: Thirty-three patients with suspected NSCLC were enrolled. Patients were examined before surgery with PET/CT and whole-body MRI including T1-weighted turbo spin echo (TSE), T2-weighted short tau inversion recovery (STIR) and DWIBS sequences (b = 0/800). Histological or cytological specimens were taken as standard of reference. Results: Whole-body MRI with DWIBS as well as PET/CT provided diagnostic image quality in all cases. Sensitivity for primary tumour detection: MRI 93%, PET/CT 98%. T-staging accuracy: MRI 63%, PET/CT 56%. N-staging accuracy: MRI 66%, PET/CT 71%. UICC staging accuracy: MRI 66%, PET/CT 74%. Sensitivity for metastatic involvement of individual lymph node groups: MRI 44%, PET/CT 47%. Specificity for individual non-metastatic lymph node groups: MRI 93%, PET/CT 96%. Assessment accuracy for individual lymph node groups: MRI 85%, PET/CT 88%. Observer agreement rate for UICC staging: MRI 74%, PET/CT 90%. Conclusion: Whole-body MRI with DWIBS provides comparable results to PET/CT in staging of NSCLC, but shows no superiority. Most relevant challenges for both techniques are T-staging accuracy and sensitivity for metastatic lymph node involvement. Key Points : • Numerous radiological methods are available for the crucial staging of lung cancer • Whole-body DWIBS MRI provides comparable results to PET/CT in NSCLC staging. • No evident superiority of whole-body DWIBS over PET/CT in NSCLC staging. • Challenges for both techniques are T-staging and detection of small metastases