The impact of PET/CT and brain MRI for metastasis detection among patients with clinical T1-category lung cancer: Findings from a large-scale cohort study

作者：Yi Feng, Bo Cheng, Shuting Zhan, Haiping Liu, Jianfu Li, Peiling Chen, Zixun Wang, Xiaoyan Huang, Xiuxia Fu, Wenjun Ye, Runchen Wang, Qixia Wang, Yang Xiang, Huiting Wang, Feng Zhu, Xin Zheng, Wenhai Fu, Guodong Hu, Zhuxing Chen, Jianxing He, Wenhua Liang · 发表于：European Journal of Nuclear Medicine and Molecular Imaging · 年份：2024 · DOI：10.1007/s00259-024-06740-8 · 被引用次数：10 · 研究领域：Lung Cancer Diagnosis and Treatment、Radiomics and Machine Learning in Medical Imaging、Lung Cancer Treatments and Mutations

PURPOSE: F]-FDG PET/CT and brain MRI are common approaches to detect metastasis in patients of lung cancer. Current guidelines for the use of PET/CT and MRI in clinical T1-category lung cancer lack risk-based stratification and require optimization. This study stratified patients based on metastatic risk in terms of the lesions' size and morphological characteristics. METHODS: The detection rate of metastasis was measured in different sizes and morphological characteristics (solid and sub-solid) of tumors. To confirm the cut-off value for discriminating metastasis and overall survival (OS) prediction, the receiver operating characteristic (ROC) analysis was performed based on PET/CT metabolic parameters (SUVmax/SUVmean/SULpeak/MTV/TLG), followed by Kaplan-Meier analysis for survival in post-operation patients with and without PET/CT plus MRI. RESULTS: 2,298 patients were included. No metastasis was observed in patients with solid nodules < 8.0 mm and sub-solid nodules < 10.0 mm. The cut-off of PET/CT metabolic parameters on discriminating metastasis were 1.09 (SUVmax), 0.26 (SUVmean), 0.31 (SULpeak), 0.55 (MTV), and 0.81 (TLG), respectively. Patients undergoing PET/CT plus MRI exhibited longer OS compared to those who did not receive it in solid nodules ≥ 8.0 mm & sub-solid nodules ≥ 10.0 mm (HR, 0.44; p < 0.001); in solid nodules ≥ 8.0 mm (HR, 0.12; p<0.001) and in sub-solid nodules ≥ 10.0 mm (HR; 0.61; p=0.075), respectively. Compared to patients with metabolic parameters l...