Abstract
BACKGROUND: Multiple models intravoxel incoherent motion (IVIM) based (18)F-fluorodeoxyglucose positron emission tomography-magnetic resonance((18)F-FDG PET/MR) could reflect the microscopic information of the tumor from multiple perspectives. However, its value in the prognostic assessment of non-small cell lung cancer (NSCLC) still needs to be further explored. OBJECTIVE: To compare the value of (18)F-FDG PET/MR metabolic parameters and diffusion parameters in the prognostic assessment of patients with NSCLC. METERIAL AND METHODS: Chest PET and IVIM scans were performed on 61 NSCLC patients using PET/MR. The maximum standard uptake value (SUV(max)), metabolic tumor volume (MTV), total lesion glycolysis (TLG), diffusion coefficient (D), perfusion fraction (f), pseudo diffusion coefficient (D*) and apparent diffusion coefficient (ADC) were calculated. The impact of SUV(max), MTV, TLG, D, f, D*and ADC on survival was measured in terms of the hazard ratio (HR) effect size. Overall survival time (OS) and progression-free survival time (PFS) were evaluated with the Kaplan-Meier and Cox proportional hazard models. Log-rank test was used to analyze the differences in parameters between groups. RESULTS: 61 NSCLC patients had an overall median OS of 18 months (14.75, 22.85) and a median PFS of 17 months (12.00, 21.75). Univariate analysis showed that pathological subtype, TNM stage, surgery, SUV(max), MTV, TLG, D, D* and ADC were both influential factors for OS and PFS in NSCLC patients. Multifactorial analysis showed that MTV, D* and ADC were independent predicting factors for OS and PFS in NSCLC patients. CONCLUSION: MTV, D* and ADC are independent predicting factors affecting OS and PFS in NSCLC patients. (18)F-FDG PET/MR-derived metabolic parameters and diffusion parameters have clinical value for prognostic assessment of NSCLC patients.