Comparison of diffusion weighted MRI parameters of mediastinal lymph nodes with PET/CT in lung cancer patients

Year 2014, Volume: 27 Issue: 1, 21 - 26, 30.09.2015

Onur Buğdaycı Mehmet Nihat Kodallı Fuat Dede İsmet Cengiç Derya Türeli Hilal Altaş Aydın Ahmet Aslan

https://doi.org/10.5472/MMJ.2013.03242.1

Cited By: 1

Abstract

ABSTRACT
Objective: We have compared diffusion-weighted magnetic
resonance imaging (DW-MRI) properties of mediastinal lymph
nodes in lung cancer patients with positron emission tomography/
computed tomography (PET/CT) findings.
Patients and Methods: Twenty-one consecutive untreated
patients with lung cancer were included. DW-MRI was performed
on a 1,5T scanner with b values of 50, 500 and 1000. Additional
MR imaging was performed for anatomical correlation.
Results: A total of 47 lymph nodes were analyzed. While no
correlation was found between minimum apparent diffusion
coefficient (ADC) values (ADCmin) of lymph nodes and their
maximum standardized uptake values (SUVmax) on PET/CT,
ADCmin ratios of lymph nodes to main lesion (ADCmin Node/
Lesion) (r = - 0.407; p = 0.005) and lymph node to cerebrospinal
fluid (ADCmin Node/CSF) (r = - 0.364; p = 0.012) were correlated
with SUVmax. Cutoff values for DW-MRI parameters were
determined using ROC analysis. Six lymph nodes were
histopathologically examined. Both methods correctly identified
one metastatic and two metastasis negative lymph nodes, while
staging one lymph node with granulomatous change as metastasis
positive. Two metastasis negative lymph nodes, reported as
suspicious on PET/CT, were correctly staged on DW-MRI.
Conclusion: Our findings indicate that DW-MRI could be at
least as valuable as PET/CT in mediastinal staging of patients with
lung cancer.

Keywords

Difüzyon manyetik rezonans görüntüleme, Pozitron-emisyon tomografi/Bilgisayarlı tomografi, Akciğer tümörleri, Lenf nodları, Mediasten

References

• Wang S, Chesnutt MS, Murray JA, Prendergast TJ. Bronchogenic carcinoma. In: McPhee SJ, Papadakis MA, editors. Current Medical Diagnosis & Treatment 2010. Forty-Ninth ed. United States: McGraw-Hill Companies Inc, 2010:1452.
• Sumi M, Sakihama N, Sumi T, et al. Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer. Am J Neuroradiol 2003;24:1627–34.
• Abdel Razek A, Soliman N, Elkhamary S, et al. Role of diffusionweighted MR imaging in cervical lymphadenopathy. Eur Radiol 2006;16:1468-77. doi:10.1007/s00330-005-0133-x.
• Usuda K, Sagawa M, Motono N, et al. Advantages of diffusionweighted imaging over positron emission tomography-computed tomography in assessment of hilar and mediastinal lymph node in lung cancer. Ann Surg Oncol 2013;20:1676-83. doi:10.1245/s10434012-2799-z.
• Nomori H, Mori T, Ikeda K, et al. Diffusion-weighted magnetic resonance imaging can be used in place of positron emission tomography for N staging of nonsmall cell lung cancer with fewer false-positive results. J Thorac Cardiovasc Surg 2008;135:816-22. doi:1016/j.jtcvs.2007.10.035.
• Hasegawa I, Boiselle PM, Kuwabara K, et al. Mediastinal lymph nodes in patients with non-small cell lung cancer: Preliminary experience with diffusion-weighted MR Imaging. J Thorac Imaging 2008;23:157-61. doi:10.1097/RTI.0b013e318166d2f5
• Koşucu P, Tekinbaş C, Erol M, et al. Mediastinal lymph nodes: Assessment with diffusion-weighted MR imaging. J Magn Reson Imaging 2009;30:292–7. doi:10.1002/jmri.21850.
• McLoud T, Bourgouin P, Greenberg R, et al. Bronchogenic carcinoma: analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling. Radiology. 1992;182:319-23. doi:10.1148/radiology.182.2.1732943.
• Webb W, Gatsonis C, Zerhouni E, et al. CT and MR imaging in staging non-cell bronchogenic carcinoma: Report of the Radiology Diagnostic Oncology group. Radiology 1991;178:705-13. doi:1148/radiology.178.3.1847239.
• Toloza E, Harpole L, McCrory D. Noninvasive staging of non-small cell lung cancer: a review of the current evidence. Chest 2003;123(1 Supplement):137-46. doi:10.1378/chest.123.1_suppl.137S.
• Wynants J, Stroobants S, Dooms C, et al. Staging of lung cancer. PET Clin 2006;1:301-16. doi:10.1016/j.cpet.2006.10.002.
• Pieterman RM, van Putten JW, Meuzelaar JJ, et al. Preoperative staging of non-small-cell lung cancer with positron-emission tomography. N Engl J Med 2000;343:254-61. doi:10.1056/ NEJM200007273430404.
• Gupta N, Graeber G, Bishop H. Comparative efficacy of positron emission tomography with fluorodeoxyglucose in evaluation of small (3 cm) lymph node lesions. Chest 2000;117:773-8. doi:10.1378/ chest.117.3.773.
• Reed CE, Harpole DH, Posther KE, et al. Results of the American College of Surgeons Oncology Group Z0050 trial: The utility of positron emission tomography in staging potentially operable nonsmall cell lung cancer. J Thorac Cardiovasc Surg 2003;126:1943-51. doi:1016/j.jtcvs.2003.07.030.
• Freudenberg LS, Rosenbaum SJ, Beyer T, et al. PET Versus PET/CT dual-modality imaging in evaluation of lung cancer. PET Clin 2006;1:347-52. doi:10.1016/j.cpet.2006.09.001.
• Antoch G, Stattaus J, Nemat AT, et al. Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology 2003;229:526-33. doi:10.1148/radiol.2292021598.
• Gupta NC, Tamim WJ, Graeber GG, et al. Mediastinal lymph node sampling following Positron Emission Tomography with fluorodeoxyglucose imaging in lung cancer staging. Chest 2001;120:521-7. doi:10.1378/chest.120.2.521.
• Graeter TP, Hellwig D, Hoffmann K, et al. Mediastinal lymph node staging in suspected lung cancer: Comparison of positron emission tomography with F-18-fluorodeoxyglucose and mediastinoscopy. Ann Thorac Surg 2003;75:231-6. doi:10.1016/S0003-4975(02)04350-3.
• Roberts PF, Follette DM, von Haag D, et al. Factors associated with false-positive staging of lung cancer by positron emission tomography. Ann Thorac Surg 2000;70:1154-60. doi:10.1016/S00034975(00)01769-0.
• Al-Sarraf N, Aziz R, Doddakula K, et al. Factors causing inaccurate staging of mediastinal nodal involvement in non-small cell lung cancer patients staged by positron emission tomography. Interact Cardiovasc Thorac Surg 2007;6:350-3. doi:10.1510/icvts.2006. 150664.
• King AD, Ahuja AT, Yeung DK, et al. Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 2007;245:806–13. doi:10.1148/radiol. 2451061804. de Bondt RB, Hoeberigs MC, Nelemans PJ, et al. Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma. Neuroradiology 2009;51:183–92. doi:1007/s00234-008-0487-2.
• Vandecaveye V, De Keyzer F, Hermans R. Diffusion weighted magnetic resonance imaging in neck lymph adenopathy. Cancer Imaging 2008;30:173–80. doi:10.1102/1470-7330.2008.0025.
• Park SO, Kim JK, Kim KA, et al. Relative apparent diffusion coefficient: determination of reference site and validation of benefit for detecting metastatic lymph nodes in uterine cervical cancer. J Magn Reson Imaging 2009;29:383–90. doi:10.1002/jmri.21635.
• Froehlich JM, Thoeny HC. Evaluation of lymph nodes using DW-MRI. In: Koh D M, Thoeny HC, editors. Diffusion-Weighted MR Imaging: Applications in the Body. Berlin Heidelberg: SpringerVerlag, 2010: 187-206. doi:10.1007/978-3-540-78576-7.
• Takahara T, Imai Y, Yamashita T, et al. 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;22:275-82.
• Kwee TC, Takahara T, Luijten PR, et al. ADC measurements of lymph nodes: Inter- and intra-observer reproducibility study and an overview of the literature. Eur J Radiol 2010;75:215-20. doi:1016/j.ejrad.2009.03.026.
• Whittaker CS, Coady A, Culver L, et al. Diffusion-weighted MR Imaging of female pelvic tumors: A pictorial review. Radiographics 2009;29:759–8. doi:10.1148/rg.293085130.
• Uto T, Takehara Y, Nakamura Y, et al. Higher sensitivity and specificity for diffusion-weighted Imaging of malignant lung lesions without apparent diffusion coefficient quantification. Radiology 2009;252:247-54. doi:10.1148/radiol.2521081195.
• Mamata H, Jolesz FA, Maier SE. Apparent diffusion coefficient and fractional anisotropy in spinal cord: Age and cervical spondylosis– related changes. J Magn Reson Imaging 2005;22:38–43. doi:10.1002/ jmri.20357.