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Predictive Value of 18 F-FDG PET/MRI for Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than
Annan Zhang1, Xiangxi Meng1, Yuan Yao1
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China.
Background:
Positron emission tomography (PET)/MRI combines the characteristics of metabolism imaging and high soft tissue resolution, and could provide high diagnostic efficacy for assessment of pleural invasion (PI) of lung cancer.
Purpose:
To investigate the application of 18 F-fluorodeoxyglucose (FDG) PET/MRI for predicting PI of lung cancer with the maximum diameter ≤3 cm.
Study Type:
Prospective.
Population:
A total of 44 patients with non-small cell lung cancer (NSCLC), age from 39 to 79 years old, including 19 (56.82%) females.
Field Strength/Sequence:
A 3-T, hybrid PET/MRI including axial fast spin echo respiratory-triggered T2 fat-suppressed imaging (T2FS) and echo planar imaging diffusion-weighted imaging (DWI).
Assessment:
The maximum standardized uptake value (SUVmax) of all lesions was measured on PET images. Localized effusion outside the contact between the nodules and the pleura on T2FS and signal at the contact between the nodules and the pleura on DWI were evaluated by experienced physicians through visual assessment of the MRI sequences.
Statistical Tests:
Three models (models 1-3) were developed, incorporating CT, CT and PET, PET and MRI features, and Lasso regression was used in feature selection. The receiver operating characteristic (ROC) curve for PI diagnosis was visualized for each model, and the area under the curve (AUC) was calculated. The DeLong test was used to compare the different AUCs. A P value < 0.05 was considered statistically significant.
Results:
The AUC of models 1-3 was 0.762, 0.829, and 0.915, respectively. The DeLong test showed a statistically significant difference between the AUCs of model 1 vs. model 3, while the differences between the AUCs of model 1 vs. model 2 (P = 0.253) and model 2 vs. model 3 (P = 0.075) were not statistically significant.
Data Conclusion:
18 F-FDG PET/MRI might show high predictive value for lung adenocarcinoma smaller than 3 cm with PI.
Evidence Level:
1 TECHNICAL EFFICACY: Stage 2.
Insights
Positron emission tomography (PET)/MRI shows high predictive value for assessing pleural invasion in lung cancer. This imaging technique aids in diagnosing smaller lung adenocarcinomas with potential pleural involvement.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Positron emission tomography (PET)/MRI integrates metabolic imaging with high soft tissue resolution.
- This combination offers potential for high diagnostic efficacy in assessing pleural invasion (PI) of lung cancer.
Purpose of the Study:
- To evaluate the utility of 18F-fluorodeoxyglucose (FDG) PET/MRI in predicting pleural invasion (PI) for lung cancers with a maximum diameter of 3 cm or less.
Main Methods:
- A prospective study involving 44 non-small cell lung cancer (NSCLC) patients.
- Utilized a 3-T hybrid PET/MRI scanner with T2 fat-suppressed imaging (T2FS) and diffusion-weighted imaging (DWI).
- Developed three predictive models incorporating CT, PET, and MRI features, using Lasso regression for feature selection and ROC analysis for diagnostic performance.
Main Results:
- The developed models (Model 1: CT, Model 2: CT+PET, Model 3: PET+MRI) achieved Areas Under the Curve (AUC) of 0.762, 0.829, and 0.915, respectively.
- Model 3 (PET+MRI) demonstrated the highest AUC, indicating superior predictive value.
- Statistical analysis showed a significant difference between Model 1 and Model 3, suggesting the added value of PET/MRI features.
Conclusions:
- 18F-FDG PET/MRI demonstrates significant potential for predicting pleural invasion in lung adenocarcinomas measuring less than 3 cm.
- The integration of PET and MRI features in predictive models enhances diagnostic accuracy for pleural invasion.
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