Whole-body diffusion weighted imaging and pathogenesis for lung cancer

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K10694
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Respiratory surgery
• Research Institution: Kanazawa Medical University
• Principal Investigator: USUDA Katsuo 金沢医科大学, 医学部, 教授 (00324046)
• Co-Investigator(Kenkyū-buntansha): 道合 万里子 金沢医科大学, 医学部, 助教 (40515673) ; 上田 善道 金沢医科大学, 医学部, 教授 (50271375) ; 的場 宗孝 金沢医科大学, 医学部, 教授 (90288308)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: MRI / MR拡散強調画像 / 肺癌 / 縦隔腫瘍 / 悪性胸膜中皮腫 / PET-CT / response evaluation / DWIBS

Outline of Final Research Achievements

Diagnostic efficacy by DWI for pulmonary nodules and masses and the evaluation of N factor and M factor in lung cancer are equivalent to or more than that of FDG-PET/CT. Evaluation by DWI for patients with multiple hilar and mediastinal lymph nodes with FDG accumulation is useful for distinguishing benign from malignant conditions. The diagnostic capability of whole-body DWI (WB-DWI) for the staging of clinically operable lung cancers is equivalent to that of FDG-PET/CT and brain MRI. ADC was not a significant prognostic factor that is correlated to T factor, N factor, or cell differentiation. Functional evaluation of DWI is better than that of CT for the response evaluation of chemotherapy and/or radiotherapy to recurrent tumors of lung cancer. The medical cost of MRI is 81-84% cheaper than that of FDG-PET/CT. MRI has no
radiation exposure and is preferable for the examinations of children.

Free Research Field

呼吸器外科学

Academic Significance and Societal Importance of the Research Achievements

MR拡散強調画像 (magnetic resonance diffusion-weighted imaging, DWI）は、肺腫瘤の良悪性の鑑別診断、肺癌のN因子・病期診断、縦隔病変の良悪性の鑑別診断に有用である。また、MR拡散強調画像は、肺癌の再発病変に対する放射線・化学療法の治療効果の判定に、CTより有用である。MR拡散強調画像は、今後肺癌の質的診断で利便性が高く、炎症で偽陽性となるPET-CTの弱点を補うことが可能である。また、造影剤を使用しない全身性拡散強調画像DWIBSは、一度に全身の病変の検索が可能で、放射線被爆の問題がなく、患者の経済負担を軽減し、国民医療費の削減に貢献できる。