Abstract
BackgroundComputed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy. CT has difficulties differentiating between tumor, atelectasis and radiation induced lung toxicity (RILT). Diffusion-weighted imaging (DWI) may enable a more accurate detection of vital tumor tissue. The aim of this study was to determine the diagnostic value of MRI versus CT in the follow-up of NSCLC.MethodsTwelve patients with NSCLC stages I-III scheduled for radiochemotherapy were enrolled in this prospective study. CT with i.v. contrast agent and non enhanced MRI were performed before and 3, 6 and 12 months after treatment. Standardized ROIs were used to determine the apparent diffusion weighted coefficient (ADC) within the tumor. Tumor size was assessed by the longest longitudinal diameter (LD) and tumor volume on DWI and CT. RILT was assessed on a 4-point-score in breath-triggered T2-TSE and CT.ResultsThere was no significant difference regarding LD and tumor volume between MRI and CT (p ≥ 0.6221, respectively p ≥ 0.25). Evaluation of RILT showed a very high correlation between MRI and CT at 3 (r = 0.8750) and 12 months (r = 0.903). Assessment of the ADC values suggested that patients with a good tumor response have higher ADC values than non-responders.ConclusionsDWI is equivalent to CT for tumor volume determination in patients with NSCLC during follow up. The extent of RILT can be reliably determined by MRI. DWI could become a beneficial method to assess tumor response more accurately. ADC values may be useful as a prognostic marker.
Highlights
Computed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy
The aim of our study was to determine the diagnostic value of MRI, especially Diffusion-weighted imaging (DWI), versus CT in the followup of NSCLC patients after radiochemotherapy
Patients’ and treatment characteristics Twelve patients (3 female, 9 male) with histologically proven NSCLC were included in the study between July 2013 and November 2015
Summary
Computed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy. An actuarial locoregional recurrence rate of 40% after 3 years was reported by Garg et al [4], in Jagoda et al Cancer Imaging (2021) 21:15 another retrospective report of Kandi et al 67 of 137 patients (48,9%) experienced a locoregional recurrence after chemoradiotherapy [5]. An early diagnosis of recurrence or detecting a lack of tumor response is essential to provide the patient with an alternative treatment approach such as immunotherapy. For this reason, surveillance is important for monitoring the primary tumor site and detecting metastases
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