Prognostic evaluation value of 18F-FDG PET/MR metabolic and diffusion parameters in non-small cell lung cancer patients
Objective:To investigate the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography magnetic resonance (PET/MR) metabolic parameters and diffusion parameters in the prognosis of patients with non-small cell lung cancer (NSCLC). Materials and Methods:Prospective 3.0 T chest 18F-FDG PET/MR hybrid scans were performed in patients suspected of having lung space occupying lesions by CT examination in Henan Provincial People's Hospital from July 8,2020 to July 29,2021. The relationship between the maximum standardized uptake value (SUVmax) and apparent diffusion coefficient (ADC) of scanned images and clinical possible prognostic factors was analyzed. Kaplan Meier method,log rank test and univariate and multivariate Cox regression were used to analyze the relationship between metabolic parameter SUVmax and diffusion parameter ADC and overall survival (OS) and progression free survival (PFS). Results:The median SUVmax and ADC of 48 NSCLC patients were 5.87 (3.92,9.66) and 1.41 (1.28,1.57),respectively. Univariate analysis showed that whether surgery[HR=6.704,95％ confidence interval (CI):1.422-31.614,P=0.016;HR=7.174,95％ CI:1.486-34.626,P=0.014],SUVmax (HR=1.170,95％ CI:1.010-1.355,P=0.036;HR=1.173,95％ CI:1.010-1.360,P=0.035) and ADC (HR=0.010,95％ CI:0.000-0.232,P=0.004;HR=0.006,95％ CI:0. 000-0.156,P=0.002) were the influencing factors of PFS and OS in NSCLC patients. Multivariate analysis showed that ADC (HR=0.012,95％ CI:0.000-0.386,P=0.012;HR=0.008,95％ CI:0.000-0.298,P=0.009) was an independent risk factor for PFS and OS in NSCLC patients. Conclusions:Both SUVmax and ADC are prognostic factors for NSCLC patients,and ADC may be more helpful in predicting the prognosis of NSCLC patients than SUVmax. 18F-FDG PET/MR metabolic parameters and diffusion parameters have certain value for the prognosis evaluation of NSCLC patients.
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