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Correlation of Quantitative Diffusion-Weighted MR Parameters and SUVmax from 18-FDG PET-CT in Lung Cancer: A Prospective Observational StudyFunding This study was supported by a grant from the Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC) scientific committee for thoracic MRI sequences in 29 patients with lung cancer after an institutional review board (IRB) approval.
Background Diffusion-weighted magnetic resonance imaging (DW-MRI) sequences report the cellularity in tissues and 18-fluorodeoxyglucose (18-FDG) positron emission tomography–computed tomography (PET-CT) provides information on glucose metabolism in cells, associated to tumor aggressiveness. The aim of this study was to assess the correlation between quantitative diffusion-weighted magnetic resonance parameters and maximum standardized uptake value (SUVmax) using 18-FDG PET-CT in lung cancer and metastatic lymph nodes.
Methods Histologically proven 29 patients of lung cancers were subjected to 18-FDG PET-CT and DW-MRI (parameters: repetition time/time to echo [TR/TE] = 4,000/76 ms; b-values = 0, 400, and 800 s/mm2) between June 2018 and June 2019. SUVmax was calculated on the PET-CT images representing region of interest (ROI) in the tumor. The apparent diffusion coefficient (ADC) values were quantified by placing an ROI over the tumor at a high b-value of 800 mm2/s. Statistical analyses for correlation between SUVmax and ADC were done using Pearson's correlation coefficient (r).
Results Significant negative correlation was observed between analyses of ADC and SUVmax for primary lesions of all nonsmall-cell lung cancers (NSCLCs; p < 0.05) and its histological subtype adenocarcinoma (p < 0.05) but not squamous cell carcinomas (p = 0.35). Significant negative correlation was also observed for metastatic lymph nodes of adenocarcinoma (p < 0.05) but not for metastatic lymph nodes of all NSCLCs (p = 0.05) or squamous cell carcinomas (p = 0.55).
Conclusions Diffusion-weighted imaging (DWI) with ADC may represent a new prognostic marker due to a significant negative correlation between ADC determined by DWI and SUVmax by PET-CT in NSCLCs. Furthermore, DWI-MRI of the thorax can be added to routine 18-FDG PET-CT for staging and response assessment in lung cancer in prospects.
Keywords18-FDG PET-CT - apparent diffusion coefficient (ADC) - nonsmall-cell lung cancer (NSCLC) - SUVmax
Article published online:
09 June 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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- 1 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
- 2 Ettinger DS, Aisner DL, Wood DE. et al. NCCN guidelines insights: non-small cell lung cancer, Version 5.2018. J Natl Compr Canc Netw 2018; 16 (07) 807-821
- 3 De Wever W, Stroobants S, Coolen J, Verschakelen JA. Integrated PET/CT in the staging of nonsmall cell lung cancer: technical aspects and clinical integration. Eur Respir J 2009; 33 (01) 201-212
- 4 Kligerman S, Digumarthy S. Staging of non-small cell lung cancer using integrated PET/CT. AJR Am J Roentgenol 2009; 193 (05) 1203-1211
- 5 Nahmias C, Hanna WT, Wahl LM, Long MJ, Hubner KF, Townsend DW. Time course of early response to chemotherapy in non-small cell lung cancer patients with 18F-FDG PET/CT. J Nucl Med 2007; 48 (05) 744-751
- 6 Borst GR, Belderbos JS, Boellaard R. et al. Standardised FDG uptake: a prognostic factor for inoperable non-small cell lung cancer. Eur J Cancer 2005; 41 (11) 1533-1541
- 7 Regier M, Kandel S, Kaul MG. et al. Detection of small pulmonary nodules in high-field MR at 3 T: evaluation of different pulse sequences using porcine lung explants. Eur Radiol 2007; 17 (05) 1341-1351
- 8 Matoba M, Tonami H, Kondou T. et al. Lung carcinoma: diffusion-weighted MR imaging–preliminary evaluation with apparent diffusion coefficient. Radiology 2007; 243 (02) 570-577
- 9 Takahara T, Imai Y, Yamashita T, Yasuda S, Nasu S, Van Cauteren M. Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. Radiat Med 2004; 22 (04) 275-282
- 10 Theilmann RJ, Borders R, Trouard TP. et al. Changes in water mobility measured by diffusion MRI predict response of metastatic breast cancer to chemotherapy. Neoplasia 2004; 6 (06) 831-837
- 11 Tyng CJ, Guimarães MD, Bitencourt AG. et al. Correlation of the ADC values assessed by diffusion-weighted MRI and 18 F–FDG PET/CT SUV in patients with lung cancer. Applied Cancer Research. 2018; 38 (01) 1-7
- 12 Regier M, Derlin T, Schwarz D. et al. Diffusion weighted MRI and 18F-FDG PET/CT in non-small cell lung cancer (NSCLC): does the apparent diffusion coefficient (ADC) correlate with tracer uptake (SUV)?. Eur J Radiol 2012; 81 (10) 2913-2918
- 13 Heusch P, Buchbender C, Köhler J. et al. Correlation of the apparent diffusion coefficient (ADC) with the standardized uptake value (SUV) in hybrid 18F-FDG PET/MRI in non-small cell lung cancer (NSCLC) lesions: initial results. RöFo-Fortschritte auf demGebiet der Röntgenstrahlen und der bildgebendenVerfahren 2013; 185 (11) 1056-1062
- 14 Warburg O. On the origin of cancer cells. Science 1956; 123 (3191): 309-314
- 15 Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A, Gourtsoyiannis N. Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 2008; 18 (03) 486-492
- 16 Pauls S, Schmidt SA, Juchems MS. et al. Diffusion-weighted MR imaging in comparison to integrated [18F]-FDG PET/CT for N-staging in patients with lung cancer. Eur J Radiol 2012; 81 (01) 178-182
- 17 Cerfolio RJ, Bryant AS, Ohja B, Bartolucci AA. The maximum standardized uptake values on positron emission tomography of a non-small cell lung cancer predict stage, recurrence, and survival. J Thorac Cardiovasc Surg 2005; 130 (01) 151-159
- 18 Iizuka Y, Matsuo Y, Umeoka S. et al. Prediction of clinical outcome after stereotactic body radiotherapy for non-small cell lung cancer using diffusion-weighted MRI and (18)F-FDG PET. Eur J Radiol 2014; 83 (11) 2087-2092
- 19 Ohno Y, Koyama H, Yoshikawa T. et al. Diffusion-weighted MRI versus 18F-FDG PET/CT: performance as predictors of tumor treatment response and patient survival in patients with non-small cell lung cancer receiving chemoradiotherapy. AJR Am J Roentgenol 2012; 198 (01) 75-82
- 20 Yabuuchi H, Hatakenaka M, Takayama K. et al. Non-small cell lung cancer: detection of early response to chemotherapy by using contrast-enhanced dynamic and diffusion-weighted MR imaging. Radiology 2011; 261 (02) 598-604
- 21 Yu J, Li W, Zhang Z, Yu T, Li D. Prediction of early response to chemotherapy in lung cancer by using diffusion-weighted MR imaging. Scientific World J 2014; 2014: 135841
- 22 Tsuchida T, Morikawa M, Demura Y, Umeda Y, Okazawa H, Kimura H. Imaging the early response to chemotherapy in advanced lung cancer with diffusion-weighted magnetic resonance imaging compared to fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography. J Magn Reson Imaging 2013; 38 (01) 80-88
- 23 Chang Q, Wu N, Ouyang H, Huang Y. Diffusion-weighted magnetic resonance imaging of lung cancer at 3.0 T: a preliminary study on monitoring diffusion changes during chemoradiation therapy. Clin Imaging 2012; 36 (02) 98-103
- 24 Dudeck O, Zeile M, Pink D. et al. Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging 2008; 27 (05) 1109-1113
- 25 Schaarschmidt BM, Buchbender C, Nensa F. et al. Correlation of the apparent diffusion coefficient (ADC) with the standardized uptake value (SUV) in lymph node metastases of non-small cell lung cancer (NSCLC) patients using hybrid 18F-FDG PET/MRI. PLoS One 2015; 10 (01) e0116277
- 26 Usuda K, Zhao XT, Sagawa M. et al. Diffusion-weighted imaging is superior to positron emission tomography in the detection and nodal assessment of lung cancers. Ann Thorac Surg 2011; 91 (06) 1689-1695
- 27 Bruckmann NM, Kirchner J, Grueneisen J. et al. Correlation of the apparent diffusion coefficient (ADC) and standardized uptake values (SUV) with overall survival in patients with primary non-small cell lung cancer (NSCLC) using 18F-FDG PET/MRI. Eur J Radiol 2021; 134: 109422