Correlation of the Apparent Diffusion Coefficient (ADC) with the Standardized Uptake Value (SUV) in Hybrid 18F-FDG PET/MRI in Non-Small Cell Lung Cancer (NSCLC) Lesions: Initial Results

Abstract

Purpose: To compare the apparent diffusion coefficient (ADC) in non-small cell lung cancer lesions with standardized uptake values (SUV) derived from combined 18F-fluoro-deoxy-glucose-positron emission tomography/magnetic resonance imaging (FDG-PET/MRI) and those derived from FDG-PET/CT.

Materials and Methods: In 18 consecutive patients with histologically proven NSCLC (17 men, 1 woman; mean age, 61 ± 12 years), whole-body FDG-PET/MRI was performed after whole-body FDG-PET/CT. Regions of interest (ROI) encompassing the entire primary tumor were drawn into FDG-PET/CT and FDG-PET/MR images to determine the maximum and mean standardized uptake value (SUV_max; SUV_mean) and into ADC parameter maps to assess mean ADC values. Pearson’s correlation coefficients were calculated to compare SUV and ADC values.

Results: The SUV_max of NSCLC was 12.3 ± 4.8 [mean ±SD], and the SUV_mean was 7.2 ± 2.8 as assessed by FDG-PET/MRI. The SUV_max and SUV_mean derived from FDG-PET/CT and FDG-PET/MRI correlated well (R = 0.93; p < 0.001 and R = 0.92; p < 0.001, respectively). The ADCmean of the pulmonary tumors was 187.9 ± 88.8 × 10^{–5 mm²/s} [mean ± SD]. The ADC_mean exhibited a significant inverse correlation with the SUV_max (R = –0.72; p < 0.001) as well as with the SUVmean assessed by FDG-PET/MRI (R = –0.71; p < 0.001).

Conclusion: This simultaneous PET/MRI study corroborates the assumed significant inverse correlation between increased metabolic activity on FDG-PET and restricted diffusion on DWI in NSCLC.

Citation Format:

• Heusch P, Buchbender C, Köhler J et al. Correlation of the Apparent Diffusion Coefficient (ADC) with the Standardized Uptake Value (SUV) in Hybrid 18F-FDG PET/MRI in Non-Small Cell Lung Cancer (NSCLC) Lesions: Initial Results. Fortschr Röntgenstr 2013; 185: 1056 – 1062

Zusammenfassung

Ziel: Vergleich der in der kombinierten 18F-FDG-PET/MR bzw. 18F-FDG-PET/CT ermittelten, scheinbaren Diffusionskoeffizienten (ADC) und der „standardized uptake values” (SUV) bei nichtkleinzelligen Bronchialkarzinomen (NSCLC).

Material und Methoden: Bei 18 konsekutiven Patienten mit histologisch gesichertem NSCLC (17 Männer, 1 Frau, mittleres Alter: 61 ± 12 Jahre) wurde nach einer Ganzkörper-FDG-PET/CT eine Ganzkörper-FDG-PET/MR durchgeführt. Um den maximalen und mittleren SUV (SUV_max; SUV_mean) zu bestimmen, wurden die Grenzen des Primärtumors identifiziert und ein „volume of interest“ (VOI) in der FDG-PET/CT und FDG-PET/MR platziert. Eine „region of interest“ (ROI) wurde manuell, den ganzen Tumor umfassend, in die Bilder der diffusionsgewichteten Sequenzen (b = 0) eingezeichnet und anschließend in die Parameterkarten transferiert, um die ADC-Werte zu ermitteln. Um die SUV- und ADC-Werte zu vergleichen, wurde der Pearson Korrelationskoeffizient gebildet.

Ergebnisse: Der SUV_max der NSCLC betrug 12,3 ± 4.8 [Mittelwert ± Standardabweichung], der SUV_mean betrug 7,2 ± 2,8, gemessen in der FDG-PET/MR. Die mit Hilfe der FDG-PET/CT und FDG-PET/MR gemessenen SUV_max- und SUV_mean-Werte korrelierten jeweils sehr gut (R = 0,93; p < 0,001 und R = 0,92; p < 0,001). Der mittlere ADC (ADC_mean) der Lungentumore war 187,9 ± 88.8 × 10^{–5 mm²/s} [Mittelwert ± Standardabweichung]. Der mit Hilfe der FDG-PET/MR gemessene ADC_mean wies eine signifikante, inverse Korreltion mit dem SUV_max (R = –0,72; p < 0,001) als auch mit dem SUV_mean (R = –0,71; p < 0,001) auf.

Schlussfolgerung: Es besteht sowohl eine exzellente Korrelation zwischen dem SUV_max und SUV_mean, ermittelt in der FDG-PET/CT und der darauf folgenden FDG-PET/MR, als auch eine signifikante, inverse Korrealtion zwischen dem SUV_max, dem SUV_mean und dem ADC_mean, ermittelt mit Hilfe der FDG-PET/MR.

Key words

thorax - MR diffusion/perfusion - PET-CT

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