Application of dynamic contrast-enhanced MRI parameters in predicting lymph node metastasis in non-small cell lung cancer
Tian Zhongyu
Su Haoran
Song Xuan
Liang Zhihong
Abstract：Objective To explore the value of the prediction model based on dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters in predicting lymph node metastasis in non-small cell lung cancer(NSCLC).Methods A retrospective study was conducted and 310 patients with NSCLC admitted to the Second People's Hospital of Hengshui in Hebei Province from March 2020 to February 2024 were enrolled in this study.All patients underwent DCE-MRI scan before surgery.According to surgical and pathological results,the subjects were divided into metastasis group(n=113)and non-metastasis group(n=197).General information,laboratory indexes and DCE-MRI parameters[volume transfer constant(K trans),extracellular extravascular space volume fraction(Ve),plasma volume fraction(V p)and rate constant(K ep)]of the two groups were compared.Multivariate logistic regression model was used to analyze the inde-pendent risk factors for lymph node metastasis in NSCLC.A risk prediction model was constructed based on the analysis re-sults and the goodness of fit of the prediction model was evaluated by Homser-Lemeshow test.The receiver operating char-acteristic(ROC)curve was used to evaluate the efficacy of the model for predicting lymph node metastasis in NSCLC.Re-sults Preoperative serum carcinoembryonic antigen(CEA),cytokeratin fragment antigen 21-1(CYFRA21-1),free prostate-specific antigen(f-PSA)and human growth hormone(HGH)levels in the metastasis group were higher than those in the non-metastasis group,while K trans and Ve were higher than those in the non-metastasis group(P＜0.05).There was no sig-nificant difference in V p or K ep between the two groups(P＞0.05).Multivariate logistic regression analysis found that preoperative f-PSA,preoperative HGH,K trans and Ve were risk factors for lymph node metastasis(P＜0.05).A prediction model was constructed as follows:Logistic(P)=3.654-1.037 × preoperative f-PSA-1.134 × preoperative HGH-1.206 ×K trans-1.253 ×Ve.Homser-Lemeshow goodness of fit test showed 2=6.287,P＞0.05.ROC curve analysis showed that the areas under the curve(AUCs)of K trans and Ve for predicting lymph node metastasis in NSCLC were 0.590 and 0.616,re-spectively.The AUC of the prediction model was 0.808,which was greater than that of each index(Z/P=5.824/＜0.001,4.923/＜0.001).Conclusion DCE-MRI parameters(K trans and Ve)are related to lymph node metastasis in NSCLC.The prediction model constructed by combining above parameters with preoperative f-PSA and preoperative HGH demonstrates good predictive efficacy for lymph node metastasis in NSCLC.
Keywords：Non-small cell lung cancerLymph node metastasisDynamic contrast-enhanced magnetic resonance imaging parameterPrediction
Publication Date：2025-05-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 575-579 )