Diagnostic Performance of Whole-Body Diffusion-Weighted Imaging Compared to PET-CT Plus Brain MRI in Staging Clinically Resectable Lung Cancer

Document Type: Systematic Review and Meta-analysis

Authors

1 Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan

2 Department of Thoracic Surgery, Kanazawa Medical University, Daigaku, Uchinada, Ishikawa, Japan

3 Department of Radiology,Kanazawa Medical University, Daigaku, Uchinada, Ishikawa, Japan

4 Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, Daigaku, Uchinada, Ishikawa, Japan

Abstract

Background: Precise staging of lung cancer is usually evaluated by PET-CT and brain MRI. Recently, however, whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) has be applied. The aim of this study is to determine whether the diagnostic performance of lung cancer staging by WB-DWI is superior to that of PET-CT+brain MRI.
Materials and Methods: PET-CT + brain MRI and WB-DWI were used for lung cancer staging before surgery with 59 adenocarcinomas, 16 squamous cell carcinomas and 6 other carcinomas.
Results: PET-CT + brain MRI correctly identified the pathologic N staging in 67 patients (82.7%), with overstaging in 5 (6.2%) and understaging in 9 (11.1%), giving a staging accuracy of 0.827. WB-DWI correctly identified the pathologic N staging in 72 patients (88.9%), with overstaging in 1 (1.2%) and understaging in 8 patients (9.9%), giving a staging accuracy of 0.889. There were no significant differences in accuracies. PET-CT + brain MRI correctly identified the pathologic stages in 56 patients (69.1%), with overstaging in 7 (8.6%) and understaging in 18 (22.2%), giving a staging accuracy of 0.691. WB-DWI correctly identified the pathologic stages in 61 patients (75.3%), with overstaging in 4 (4.9%) and understagings in16(19.7%), giving a staging accuracy of 0.753. There were no significant difference in accuracies.
Conclusions: Diagnostic efficacy of WB-DWI for lung cancer staging is equivalent to that of PET-CT + brain MRI.

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