STIR turbo SE MR imaging vs. coregistered FDG-PET/CT: Quantitative and qualitative assessment of N-stage in non-small-cell lung cancer patients

✍ Scribed by Yoshiharu Ohno; Hisanobu Koyama; Munenobu Nogami; Daisuke Takenaka; Takeshi Yoshikawa; Masahiro Yoshimura; Chiho Ohbayashi; Kazuro Sugimura

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 559 KB
• Volume: 26
• Category: Article
• ISSN: 1053-1807
• DOI: 10.1002/jmri.21106

✦ Synopsis

Abstract

Purpose

To conduct a prospective comparison of the accuracy of short inversion time (TI) inversion‐recovery (STIR) turbo spin‐echo (SE) imaging and coregistered 2‐[fluorine‐18] fluoro‐2‐deoxy‐D‐glucose (FDG)–positron emission tomography (PET) with computed tomography (CT) (coregistered FDG‐PET/CT) to assess the N‐stage in non‐small‐cell lung cancer (NSCLC) patients.

Materials and Methods

A total of 115 consecutive NSCLC patients prospectively underwent CT, STIR turbo SE imaging, and FDG‐PET, as well as surgical and pathological examinations. All STIR turbo SE images were obtained with a 0.9% saline phantom, which was placed alongside the chest wall of each patient, and coregistered FDG‐PET/CTs were reconstructed using commercially available software. For quantitative assessments, the ratio of signal intensity (SI) of each lymph node to that of 0.9% saline phantom (lymph node‐saline ratio [LSR]) and maximal standardized uptake value (SUV~max~) of each lymph node were calculated. Feasible threshold values were determined by using the receiver operating characteristic (ROC) curve‐based positive test, and diagnostic capabilities of N‐stage were compared by McNemar's test on a per patient basis.

Results

When feasible, threshold values were adopted, quantitative sensitivity (90.1%) and accuracy (92.2%) of STIR turbo SE imaging were significantly higher than those of quantitative and qualitative sensitivities (76.7% and 74.4%) and accuracies (83.5% and 82.6%) of coregistered FDG‐PET/CT on a per patient basis (P < 0.05).

Conclusion

STIR turbo SE imaging is at least as valid as coregistered FDG‐PET/CT for quantitative and qualitative assessment of the N‐stage for NSCLC patients. J. Magn. Reson. Imaging 2007;26:1071–1080. © 2007 Wiley‐Liss, Inc.