Utilization of New Imaging Modalities (DW MRI Imaging) in NSCLC Staging and Radiotherapy Planning
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- Category: Vol. 85, June 2017
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Utilization of New Imaging Modalities (DW MRI Imaging) in NSCLC Staging and Radiotherapy Planning, MOHAMED A. HASAN, MOSTAFA AL-DALY, MARIAN F. FARID and RIHAM HANY
Abstract
Background: Lung cancer represents one of the leading causes of cancer mortality worldwide, fourteen percent of all diagnosed cancers are lung cancer. Lung cancer pathology includes both Non-Small-Cell Lung Cancer (NSCLC) ac-countig for 80-85% of lung cancers, while small-cell lung cancer has been decreasing in frequency over the last few decades. CT scans with the addition of FDG PET is the standard of care for diagnosis of lung cancer; however, there is poor distinction between structures with similar electron densities, making it difficult to differentiate lung cancers from surrounding lung collapse, consolidation or pleural effusion. DW-MRI scan sequences produce image contrast that depends on differences in tissue-water mobility. By performing DWI using different b-values which is a quantitative analysis by which the calculation of Apparent Diffusion Coefficient (ADC) values is possible, and then displaying an ADC map. Restricted water diffusion demonstrates high signal intensity on DWI and lower ADC values on ADC map corresponding with foci of hypercellularity and malignancy.
Aim of the Work: The aim of the work is incorporation of MRI diffusion as one of the functional images in lung cancer staging in addition to lung radiation therapy and its impact on the different target volumes in addition to nodal detection and assessment.
Patients and Methods: This study was carried out at Kasr El-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK) in corporation with the Department of Radio-diagnosis during the period between March 2014 to January 2015. Twenty patients were recruited in the study.
Conclusion: MRI diffusion has the ability to differentiate lung cancer mass from postobstructive collapse or consolida-tion (even better than PET CT) which affect the Gross Tumor Volume (GTV) at the end, and on the return more sparing of the normal structures.