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Diffusion-weighted magnetic resonance imaging in differentiating the invasiveness of small lung adenocarcinoma
Ryota Tanaka1, Hiroyuki Horikoshi, Tsutomu Yoshida
1Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan. t-ryota@kpb.biglobe.ne.jp
Background:
Magnetic resonance imaging (MRI) with several sequences may provide a valuable additional modality for evaluating the grade of invasiveness lesions. Diffusion-weighted magnetic resonance imaging (DWI) represents the biological characteristics of tissues.
Purpose:
To retrospectively evaluate the usefulness of DWI for evaluating the invasiveness of small lung adenocarcinomas.
Material And Methods:
From May 2005 to June 2008, 46 patients with lung adenocarcinomas measuring 2 cm or less across the greatest dimension underwent a preoperative MRI study followed by surgery at the Gunma Prefectural Cancer Center. Fourteen of the tumors were bronchioloalveolar carcinomas (so-called Noguchi's type A+B group), 26 were adenocarcinomas with mixed subtypes (type C group) and six were other histological subtypes of adenocarcinomas (type D+E+F group). The mean signal intensities of a lesion (DWI) and the spinal cord (SC) were analyzed in the region of interests (ROIs), and the mean DWI/SC ratio was then calculated with the value of DWI divided by the value of SC.
Results:
The calculated mean DWI/SC ratio for the lesions were as follows: 0.448±0.261 (mean±standard deviation [SD]) for type A+B group, 0.963±0.465 for type C group, and 0.816±0.291 for type D+E+F group. The mean DWI/SC ratio of type A+B group was significantly lower than that for the type C (P = 0.0005) or type D+E+F groups (P = 0.0117).
Conclusion:
DWI may thus provide useful supplementary information before determining the surgical strategy, including a limited resection.
