title: Diffusion-weighted MR imaging using FASE sequence for 3T MR system: Preliminary comparison of capability for N-stage assessment by means of diffusion-weighted MR imaging using EPI sequence, STIR FASE imaging and FDG PET/CT for non-small cell lung cancer patients.
abstract: OBJECTIVE
  To prospectively compare the diagnostic capability of diffusion-weighted MR imaging obtained with fast advantage spin-echo sequence (FASE-DWI) and echo planar imaging sequence (EPI-DWI), short inversion time inversion recovery fast advanced spin-echo (STIR FASE) imaging and FDG PET/CT for N-stage assessment of non-small cell carcinoma (NSCLC) patients.
  
  
  METHODS
  95 consecutive operable NSCLC patients underwent STIR FASE imaging, FASE-DWI and EPI-DWI with a 3T system, integrated PET/CT, surgical treatment and pathological and follow-up examinations. Probability of lymph node metastasis was visually assessed using a 5-point visual scoring system. ROC analyses were used to compare diagnostic capability of all methods, while their diagnostic performance was also compared by means of McNemar's test on a per node basis. Finally, McNemar's test was also used for statistical comparison of accuracy of N-stage assessment.
  
  
  RESULTS
  Areas under the curve (Azs) for STIR FASE imaging (Az=0.95) and FASE-DWI (Az=0.92) were significantly larger than those for EPI-DWI (Az=0.78; p<0.0001 for STIR FSE imaging and FASE-DWI) and PET/CT (Az=0.85; p=0.0001 for STIR FSE imaging, p=0.03 for FASE-DWI) on a per node basis analysis. Accuracy of N-stage assessment using STIR FASE imaging (84.2% [80/95]) and FASE-DWI (83.2% [79/95]) was significantly higher than that using EPI-DWI (76.8% [73/95]; p=0.02 for STIR FASE imaging, p=0.03 for FASE-DWI) and PET/CT (73.7% [70/95]; p=0.002 for STIR FSE imaging, p=0.004 for FASE-DWI).
  
  
  CONCLUSIONS
  Qualitative N-stage assessments of NSCLC patients obtained with FASE-DWI as well as STIR FASE imaging are more sensitive and/or accurate than those obtained with EPI-DWI and FDG PET/CT.
authors.affiliation: Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan. Electronic address: yoshiharuohno@aol.com.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Koyama
authors.affiliation: Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takenaka
authors.affiliation: Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan.
authors.forename: Yoshimori
authors.initials: Y
authors.lastname: Kassai
authors.affiliation: Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Yui
authors.affiliation: Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Sumiaki
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Diffusion; Lung; Lung cancer; MR imaging; PET/CT; Staging