Browse > Article
http://dx.doi.org/10.17946/JRST.2021.44.6.635

Evaluation of Usefulness for Diagnosis of Lung Cancer on Integrated PET-MRI Using Decision Matrix  

Kim, Jung-Soo (Department of Radiological Technology, Dongnam Health University)
Yang, Hyun-Jin (Department of Radiological Technology, Dongnam Health University)
Kim, Yoo-Mi (Department of Radiological Technology, Dongnam Health University)
Kwon, Hyeong-Jin (Department of Nuclear Medicine, Seoul National University Hospital)
Park, Chanrok (Department of Radiological Science, Jeonju University)
Publication Information
Journal of radiological science and technology / v.44, no.6, 2021 , pp. 635-643 More about this Journal
Abstract
The results of empirical researches on the diagnosis of lung cancer are insufficient, so it is limited to objectively judge the clinical possibility and utilization according to the accuracy of diagnosis. Thus, this study retrospectively analyzed the lung cancer diagnostic performance of PET-MRI (Positron Emission Tomography-Magnetic Resonance Imaging) by using the decision matrix. This study selected and experimented total 165 patients who received both hematological CEA (Carcinoembryonic Antigen) test and hybrid PET-MRI (18F-FDG, 5.18 MBq/kg / Body TIM coil. VIVE-Dixon). After setting up the result of CEA (positive:>4 ㎍/ℓ. negative:<2.5㎍/ℓ) as golden data, the lung cancer was found in the image of PET-MRI, and then the SUVmax (positive:>4, negative:<1.5) was measured, and then evaluated the correlation and significance of results of relative diagnostic performance of PET-MRI compared to CEA through the statistical verification (t-test, P>0.05). Through this, the PET-MRI was analyzed as 96.29% of sensitivity, 95.23% of specificity, 3.70% of false negative rate, 4.76% of false positive rate, and 95.75% of accuracy. The false negative rate was 1.06% lower than the false positive rate. The PET-MRI that significant accuracy of diagnosis through high sensitivity and specificity, and low false negative rate and false positive rate of lung cancer, could acquire the fusion image of specialized soft tissue by combining the radio-pharmaceuticals with various sequences, so its clinical value and usefulness are regarded as latently sufficient.
Keywords
Lung cancer; CEA; PET-MRI; Decision matrix; Accuracy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Hartenbach M, Hartenbach S, Bechtloff W, Danz B, Kraft K, Klemenz B, et al. Combined PET/MRI improves diagnostic accuracy in patients with prostate cancer: A prospective diagnostic trial. Clin Cancer Res. 2014;20(12):3244-53.   DOI
2 Grunnet M, Sorensen JB. Carcinoembryonic antigen (CEA) as tumor marker in lung cancer. Lung Cancer. 2012;76(2):138-43.   DOI
3 Hsu WH, Huang CS, Hsu HS, Huang WJ, Lee HC, Huang BS, et al. Preoperative serum carcinoembryonic antigen level is a prognostic factor in women with early non-small-cell lung cancer. Ann Thorac Surg. 2007;83(2):419-24.   DOI
4 Matsuoka K, Sumitomo S, Nakashima N, Nakajima D, Misaki N. Prognostic value of carcinoembryonic antigen and CYFRA21-1 in patients with pathological stage I non-small cell lung cancer. Eur J Cardiothorac Surg. 2007;32(3):435-9.   DOI
5 Okada M, Nishio W, Sakamoto T, Uchino K, Yuki T, Nakagawa A, et al. Effect of histologic type and smoking status on interpretation of serum carcinoembryonic antigen value in non-small cell lung carcinoma. Ann Thorac Surg. 2004;78(3):1004-9.   DOI
6 Vickers AJ. Decision analysis for the evaluation of diagnostic tests, prediction models and molecular markers. Am Stat. 2008;62(4):314-20.   DOI
7 Killeen PR. Beyond statistical inference: A decision theory for science. Psychon Bull Rev. 2006;13(4):549-62.   DOI
8 Kubota K, Matsuzawa T, Fujiwara T, Ito M, Hatazawa J, Ishiwata K, et al. Differential diagnosis of lung tumor with positron emission tomography: A prospective study. J Nucl Med. 1990:31(12);1927-32.
9 Korea Central Cancer Registry. Annual report of cancer statistics in Korea in 2018; 2021.
10 Park JY, Jang SH. Epidemiology of Lung Cancer in Korea: Recent trends. Tuberculosis and Respiratory Diseases. 2016;79(2):58-69.   DOI
11 Papadopoulos A, Guida F, LeffondrL K, CLnLe S, Cyr D, Schmaus A, et al. Heavy smoking and lung cancer: Are women at higher risk? Result of the ICARE study. Brt J Cancer. 2014;110:1385-91.   DOI
12 Erdi YE. Limits of tumor detectability in nuclear medicine and PET. Mol Img Radionucl Ther. 2012;21(1):23-8.   DOI
13 McLean AEB, Barnes DJ, Troy LK. Diagnosing lung cancer: The complexities of obtaining a tissue diagnosis in the era of minimally invasive and personalised medicine. J Clin Med. 2018;7(7):163.   DOI
14 Kwon HW, Becker AK, Goo JM, Cheon GJ. FDG Whole-Body PET/MRI in Oncology: A systematic review. Nucl Med Mol Imaging. 2017;51(1):22-31.   DOI
15 Khiewvan B, Torigian DA, Emamzadehfard S, Paydary K, Salavati A, Houshmand S, et al. Update of the role of PET/CT and PET/MRI in the management of patients with cervical cancer. Hell J Nucl Med. 2016;19(3):254-68.
16 Lee SJ, Seo HJ, Cheon GJ, Kim JH, Kim EE, Kang KW, et al. Usefulness of integrated PET/MRI in head and neck cancer: A preliminary study. Nucl Med Mol Imaging. 2014;48(2):98-105.   DOI
17 Ehman EC, Johnson GB, Villanueva-Meyer JE, Cha S, Leynes AP, Larson PEZ, et al. PET/MRI: Where might it replace PET/CT? J Magn Reson Imaging. 2017;46(5):1247-62.   DOI
18 Delso G, Ziegler S. PET/MRI system design. Eur J Nucl Med and Mol Imaging. 2009;36:86-92.   DOI
19 Jung JH, Choi Y, Im KC. PET/MRI: Technical challenges and recent advances. Nucl Med Mol Imaging. 2016;50(1):3-12.   DOI
20 Nensa F, Beiderwellen K, Heusch P, Wetter A. Clinical applications of PET/MRI: current status and future perspectives. Diagn Interv Radiol. 2014; 20(5):438-47.   DOI
21 Duan XY, Wang W, Li M, Li Y, Guo YM. Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma. Braz J Med Biol Res. 2015;48(3):267-72.   DOI
22 BLsing KA, SchLnberg SO, Brade J, Wasser K. Impact of blood glucose, diabetes, insulin, and obesity on standardized uptake values in tumors and healthy organs on 18F-FDG PET/CT. Nucl Med Biol. 2013;40:206-13.   DOI
23 Malladi A, Viner M, Jackson T, Mercier G, Subramaniam RM. PET/CT mediastinal and liver FDG uptake: Effects of biological and procedural factors. J Med Imaging Radiat Oncol. 2013;57:169-75.   DOI
24 Franklin WA, Aisner DL, Davies KD. Pathology, biomarkers, and molecular diagnostics. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE (eds) Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:Chap 15.
25 Martinez-Moller A, Souvatzoglou M. Tissue classification as a potential approach for attenuation correction in whole-body PET-MRI. J Nucl Med. 2009;50:520-6.   DOI
26 Catana C, Van der Kouwe A, Benner T, Michel CJ. Toward implementing an MRI-based PET attenuation-correction method for neurologic studies on the MR-PET brain prototype. J Nucl Med. 2010;51:1431-8.   DOI
27 Soongsathitanon S, Masa-Ah P, Tuntawiroon M. A new standardized uptake values (SUV) calculation based on pixel intensity values. Math Comput Simul. 2012;6:26-33.
28 Jain S, Pincus MR, Bluth MH, McPherson RA, Bowne WB, Lee P. Diagnosis and management of cancer using serologic and other body fluid markers. In: McPherson RA, Pincus MR (eds) Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:Chap 74.
29 Kim JE, Kim JS, Choi NG, Han JB. Evaluation of the liver cancer diagnosis function of PET-MRI based on decision matrix analysis. J Kor Cont Asc. 2017;17(11):50-9.   DOI
30 Kang GW, Kim SE, Lee DS, Jeong JK. Koh's nuclear medicine. Kor Med. 2008;(3):8-20.
31 Okada M, Nishio W, Sakamoto T, Uchino K, Yuki T, Nakagawa A, et al. Prognostic significance of perioperative serum carcinoembryonic antigen in non-small cell lung cancer: Analysis of 1,000 consecutive resections for clinical stage I disease. Ann Thorac Surg. 2004;78(1):216-21.   DOI
32 Hutton BF, Erlandsson K, Thielemans K. Advances in clinical molecular imaging instrumentation. Clin Transl Imaging. 2018;6:31-5.   DOI
33 Cangemi V, Volpino P, Drudi FM, D'Andrea N, Cangemi R, Piat G. Assessment of the accuracy of diagnostic chest CT scanning. Impact on lung cancer management. Int Surg. 1996;81(1):77-82.
34 Kim MY. Relationship between pSUV of 18F-FDG PET/CT and pathological diagnosis in breast cancer. Journal of Radiological Science and Technology. 2013:36(4);305-11.
35 Qu X, Huang X, Yan W, Wu L, Dai K. A meta-analysis of 18FDG-PET-CT, 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with lung cancer. Eur J Radiol. 2012;81(5):1007-15.   DOI
36 RiihimLki M, Hemminki A, Fallah M, Thomsen H, Sundquist K, Sundquist J, et al. Metastatic sites and survival in lung cancer. Lung Cancer. 2014;86(1):78-84.   DOI
37 Loeffelbein DJ, Souvatzoglou M, Wankerl V, Martinez-MLller A, Dinges J, Schwaiger M, et al. PET-MRI fusion in head and neck oncology: Current status and implications for hybrid PET/MRI. J Oral Maxillofac Surg. 2012;70(2):473-83.   DOI
38 Boellaard R, Krak NC, Hoekstra OS, Lammertsma AA. Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: A simulation study. J Nucl Med. 2004;45(9):1519-27.
39 Mayerhoefer ME, Prosch H, Beer L, Tamandl D, Beyer T, Hoeller C, et al. PET/MRI versus PET/CT in oncology: A prospective single-center study of 330 examinations focusing on implications for patient management and cost considerations. Eur J Nucl and Mol Img. 2020;47:51-60.   DOI
40 Conti M, Bendriem B. The new opportunities for high time resolution clinical TOF PET. Clin Trans Img. 2019;7(2):139-47.   DOI
41 Rivera MP, Detterbeck F, Mehta AC. Diagnosis of lung cancer* The guidelines. Chest. 2003;123:129-36.   DOI
42 Ambrosini V, Nicolini S, Caroli P, Nanni C, Massaro A, Cristina Marzola M, et al. PET/CT imaging in different types of lung cancer: An overview. Eur J Radiol. 2021;81(5):988-1001.   DOI
43 Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer. Chest J. 2013;143(5): 211-50.
44 Collins LG, Haines C, Perkel R, Enck RE. Lung cancer: Diagnosis and management. Am Fam Physician. 2007;75(1):56-63.
45 Shin GS, Dong GR. The difference of standardized uptake valueon PET-CT according to change of CT parameters. Journal of Radiological Science and Technology. 2007;30(4):373-9.
46 Pournazari K, Jahangiri P, Mehdizadeh Seraj S, Khosravi M, Arani L, Torigian D, et al. PET/MRI applications in lung cancer. J Nucl Med. 2018;59(Supplement 1):1157.