• Yoshiharu Ohno, Hisanobu Koyama, Takeshi Yoshikawa, Daisuke Takenaka, Shinichiro Seki, Masao Yui, Hitoshi Yamagata, Kota Aoyagi, Sumiaki Matsumoto, and Kazuro Sugimura.
• From the Advanced Biomedical Imaging Research Center (Y.O., T.Y., S.M.), Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y., S.M.), and Division of Radiology, Department of Radiology (H.K., D.T., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Akashi 650-0017, Japan; Department of Radiology, Hyogo Cancer Center, Kobe, Japan (D.T.); and Toshiba Medical Systems Corporation, Otawara, Japan (M.Y., H.Y., K.A.).
• Radiology. 2015 Jun 1; 275 (3): 849-61.

PurposeTo prospectively compare the capabilities for TNM classification and assessment of clinical stage and operability among whole-body magnetic resonance (MR) imaging, coregistered positron emission tomographic (PET)/MR imaging with and without MR signal intensity (SI) assessment, and integrated fluorine 18 fluorodeoxyglucose (FDG) PET/computed tomography (CT) in non-small cell lung cancer (NSCLC) patients.Materials And MethodsThe institutional review board approved this study, and written informed consent was obtained from each patient. One hundred forty consecutive NSCLC patients (75 men, 65 women; mean age, 72 years) prospectively underwent whole-body MR imaging, FDG PET/CT, conventional radiologic examinations, and surgical, pathologic, and/or follow-up examinations. All factors and clinical stage and operability were then visually assessed. All PET/MR examinations were assessed with and without SI assessment. One examination used anatomic, metabolic, and relaxation-time information, and the other used only anatomic and metabolic information. κ statistics were used for assessment of all factors and clinical stages with final diagnoses. McNemar test was used to compare the capability of all methods to assess operability.ResultsAgreements of assessment of every factor (κ = 0.63-0.97) and clinical stage (κ = 0.65-0.90) were substantial or almost perfect. Regarding capability to assess operability, accuracy of whole-body MR imaging and PET/MR imaging with SI assessment (97.1% [136 of 140]) was significantly higher than that of MR/PET without SI assessment and integrated FDG PET/CT (85.0% [119 of 140]; P < .001).ConclusionAccuracies of whole-body MR imaging and PET/MR imaging with SI assessment are superior to PET/MR without SI assessment and PET/CT for identification of TNM factor, clinical stage, and operability evaluation of NSCLC patients.RSNA, 2015

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