Volumetric analysis of intravoxel incoherent motion diffusion-weighted imaging in preoperative assessment of non-small cell lung cancer

Jianqin Jiang; Yigang Fu; Lili Zhang; Jia Liu; Xiaowen Gu; Weiwei Shao; Lei Cui; Gaofeng Xu

doi:10.1007/s11604-022-01279-w

Volumetric analysis of intravoxel incoherent motion diffusion-weighted imaging in preoperative assessment of non-small cell lung cancer

Jpn J Radiol. 2022 Sep;40(9):903-913. doi: 10.1007/s11604-022-01279-w. Epub 2022 May 4.

Authors

Jianqin Jiang^#¹, Yigang Fu^#¹, Lili Zhang¹, Jia Liu², Xiaowen Gu³, Weiwei Shao⁴, Lei Cui⁵, Gaofeng Xu⁶

Affiliations

¹ Department of Radiology, The Fourth Affiliated Hospital of Nantong University and The First People's Hospital of Yancheng, No.166 Yulong West Road, Yancheng, 224001, Jiangsu, China.
² Department of Radiology, Affiliated Hospital 2 of Nantong University, No. 6 Hai'er Road, Nantong, 226001, Jiangsu, China.
³ Department of Radiology, Suzhou Municipal Hospital, Suzhou, Jiangsu, China.
⁴ Department of Pathology, The Fourth Affiliated Hospital of Nantong University and The First People's Hospital of Yancheng, Yancheng, Jiangsu, China.
⁵ Department of Radiology, Affiliated Hospital 2 of Nantong University, No. 6 Hai'er Road, Nantong, 226001, Jiangsu, China. cuigeleili@126.com.
⁶ Department of Radiology, The Fourth Affiliated Hospital of Nantong University and The First People's Hospital of Yancheng, No.166 Yulong West Road, Yancheng, 224001, Jiangsu, China. 18905100082@163.com.

^# Contributed equally.

PMID: 35507139
DOI: 10.1007/s11604-022-01279-w

Abstract

Purpose: To evaluate the potential of intravoxel incoherent motion (IVIM) and apparent diffusion coefficient (ADC) in the prediction of tumor grade, lymph node metastasis and pleural invasion of non-small cell lung cancer (NSCLC) before surgery.

Materials and methods: 65 patients diagnosed with NSCLC by surgery were enrolled. IVIM-DWI (10 b-values, 0-1000 s/mm²) was performed before surgery. The mean and minimum ADC (ADC_mean, ADC_min) and IVIM parameters D, D* and f were independently measured and calculated by 2 radiologists by drawing regions of interest (ROIs) including the solid component of the whole tumor. Intraclass correlation coefficients (ICCs) were analysed. Spearman analysis was used to determine the correlation between IVIM parameters and tumor differentiation. Independent sample t-tests (normal distribution) or Mann-Whitney U tests (non-normal distribution) were used to compare the differences between the parameters in moderately-well and poorly differentiated groups, with and without lymph node metastasis and pleural invasion groups. Receiver operating characteristic (ROC) curves were generated.

Results: The ADC_mean, ADC_min, D and f values were negatively correlated with the pathological grades of tumor (P < 0.05). The ADC_mean and D values of patients with poor differentiation and lymph node metastasis were significantly lower than that of patients with moderately-well differentiation and without lymph node metastasis (P < 0.001-0.012). The D value was significantly lower and f value was significantly higher among patients with pleural invasion than those without (P = 0.033 and < 0.001). ROC analysis showed that the area under the ROC curve (AUC) was larger for D in predicting the degree of differentiation (0.832) and lymph node metastasis (0.806), and higher for f in predicting pleural invasion (0.832).

Conclusions: IVIM is useful for predicting the tumor differentiation, lymph node metastasis and pleural invasion in NSCLC patients before surgery.

Keywords: Intravoxel incoherent motion; Lymph node metastasis; Non-small cell lung cancer; Pleural invasion; Tumor grade.

MeSH terms

Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
Carcinoma, Non-Small-Cell Lung* / surgery
Diffusion Magnetic Resonance Imaging / methods
Humans
Lung Neoplasms* / diagnostic imaging
Lung Neoplasms* / surgery
Lymphatic Metastasis / diagnostic imaging
Motion