Apparent diffusion coefficient distinguishes histologic typing of lung cancer brain metastases and its correlation with the Ki-67 proliferation index

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• Clinical Article •

ZHOU Fengyu ZHANG Bin DONG Wenjie ZHANG Peng XUE Caiqiang LIU Xianwang HAN Tao ZHOU Junlin

Cite this article as: ZHOU F Y, ZHANG B, DONG W J, et al. Apparent diffusion coefficient distinguishes histologic typing of lung cancer brain metastases and its correlation with the Ki-67 proliferation index[J]. Chin J Magn Reson Imaging, 2024, 15(2): 42-47. DOI:10.12015/issn.1674-8034.2024.02.006.

Abstract

[Abstract] Objective To investigate the value of apparent diffusion coefficient (ADC) for differential diagnosis of histological type of lung cancer brain metastases and its relationship with Ki-67 proliferation index.Materials and Methods The clinical data of 20 patients with small-cell carcinoma brain metastases and 41 patients with non-small-cell lung carcinoma brain metastases confirmed by surgery were analyzed retrospectively. The minimum ADC value (ADCmin), the mean ADC value (ADCmean), and the ADC values in contralateral normal cerebral white matter were measured on the ADC map, and the relative ADCmin value (rADCmin) and relative ADCmean value (rADCmean) were calculated. The differences in ADC values were compared and analyzed, the differential diagnostic value of ADC values was evaluated by plotting receiver operating characteristic (ROC) curves, and the correlation between ADC values and Ki-67 proliferation index was calculated.Results The ADCmin, ADCmean, rADCmin and rADCmean values of the small cell lung cancer brain metastasis tumor group were smaller than those of the non-small fine lung cancer brain metastasis tumor group, and the differences between the groups were all statistically significant (P<0.05). Each ADC value could effectively discriminate between small cell lung cancer brain metastases and non-small cell lung cancer brain metastases, among which the rADCmean value had the best differential diagnostic efficacy, with an area under the curve (AUC) of 0.950 [95% confidence interval (CI): 0.907-0.994]. The optimal cutoff value was of 0.955, and the corresponding sensitivity and specificity were 96.23% and 83.87%, respectively, and the accuracy was 91.67%. The Ki-67 proliferation index in the small cell lung cancer brain metastasis group was greater than that in the non-small cell lung cancer brain metastasis group, and the difference between the groups was statistically significant (P<0.05). A total of 61 patients with lung cancer brain metastasis showed different degrees of negative correlation between the ADCmin, ADCmean, rADCmin and rADCmean values and the Ki-67 proliferation index (r=-0.506, r=-0.480, r=-0.569, r=-0.541).Conclusions ADC values can provide differential diagnosis of histological type of lung cancer brain metastases and can predict the expression level of Ki-67 proliferation index.

[Keywords] lung neoplasms；brain metastases；magnetic resonance imaging；apparent diffusion coefficient；Ki-67 proliferation index

Contributor Information

ZHOU Fengyu^{1,
2,
3,
4}   ZHANG Bin^{1,
2,
3,
4}   DONG Wenjie^{1,
2,
3,
4}   ZHANG Peng⁵   XUE Caiqiang^{1,
2,
3,
4}   LIU Xianwang^{1,
2,
3,
4}   HAN Tao^{1,
2,
3,
4}   ZHOU Junlin^{1,
2,
3,
4*}

¹ Department of Radiology, Lanzhou University Second Hospital, Lanzhou 730030, China

² Second Clinical School, Lanzhou University, Lanzhou 730030, China

³ Key Laboratory of Medical Imaging of Gansu Province, Lanzhou 730030, China

⁴ Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou 730030, China

⁵ Department of Pathology, the Second Hospital of Lanzhou University, Lanzhou 730030, China

Corresponding author: ZHOU J L, E-mail: lzuzjl601@163.com

Conflicts of interest None.

Publication Information

Received 2023-09-18

Accepted 2024-02-01

DOI: 10.12015/issn.1674-8034.2024.02.006

Text

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