Prediction of clinical outcome after stereotactic body radiotherapy for non-small cell lung cancer using diffusion-weighted MRI and (18)F-FDG PET

Yusuke Iizuka; Yukinori Matsuo; Shigeaki Umeoka; Yuji Nakamoto; Nami Ueki; Takashi Mizowaki; Kaori Togashi; Masahiro Hiraoka

doi:10.1016/j.ejrad.2014.07.018

Prediction of clinical outcome after stereotactic body radiotherapy for non-small cell lung cancer using diffusion-weighted MRI and (18)F-FDG PET

Eur J Radiol. 2014 Nov;83(11):2087-92. doi: 10.1016/j.ejrad.2014.07.018. Epub 2014 Aug 10.

Authors

Yusuke Iizuka¹, Yukinori Matsuo², Shigeaki Umeoka³, Yuji Nakamoto³, Nami Ueki¹, Takashi Mizowaki¹, Kaori Togashi³, Masahiro Hiraoka¹

Affiliations

¹ Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
² Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: ymatsuo@kuhp.kyoto-u.ac.jp.
³ Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

PMID: 25174774
DOI: 10.1016/j.ejrad.2014.07.018

Abstract

Purpose/objectives: To evaluate the use of diffusion-weighted magnetic resonance imaging (DW-MRI) and (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for predicting disease progression (DP) among patients with non-small cell lung carcinoma (NSCLC) treated with stereotactic body radiotherapy (SBRT).

Materials/methods: Fifteen patients with histologically confirmed stage I NSCLC who underwent pre-treatment DW-MRI and PET and were treated with SBRT were enrolled. The mean apparent diffusion coefficient (ADC) value and maximum standardised uptake value (SUVmax) were measured at the target lesion and evaluated for correlations with DP.

Results: The median pre-treatment ADC value was 1.04×10(-3) (range 0.83-1.29×10(-3))mm(2)/s, and the median pre-treatment SUVmax was 9.9 (range 1.6-30). There was no correlation between the ADC value and SUVmax. The group with the lower ADC value (≤1.05×10(-3)mm(2)/s) and that with a higher SUVmax (≥7.9) tended to have poor DP, but neither trend was statistically significant (p=0.09 and 0.32, respectively). The combination of the ADC value and SUVmax was a statistically significant predictor of DP (p=0.036).

Conclusion: A low ADC value on pre-treatment DW-MRI and a high SUVmax may be associated with poor DP in NSCLC patients treated with SBRT. Using both values in combination was a better predictor.

Keywords: Diffusion-weighted MRI; FDG-PET; Lung cancers; Stereotactic body radiotherapy.

Publication types

Evaluation Study

MeSH terms

Adult
Aged
Carcinoma, Non-Small-Cell Lung / diagnosis
Carcinoma, Non-Small-Cell Lung / pathology
Carcinoma, Non-Small-Cell Lung / radiotherapy*
Diffusion Magnetic Resonance Imaging* / methods
Female
Fluorodeoxyglucose F18*
Humans
Lung Neoplasms / diagnosis
Lung Neoplasms / pathology
Lung Neoplasms / radiotherapy*
Male
Middle Aged
Multimodal Imaging
Observer Variation
Positron-Emission Tomography* / methods
Radiopharmaceuticals*
Radiosurgery / methods*
Reproducibility of Results
Sensitivity and Specificity

Substances

Radiopharmaceuticals
Fluorodeoxyglucose F18