Value of PET/MRI for assessing tumor resectability in NSCLC—intra-individual comparison with PET/CT
Bibliographic record
Abstract
Objective: The purpose of this study was to compare the diagnostic accuracy of positron emission tomography (PET)/MRI with PET/CT for determining tumor resectability of non-small cell lung cancer (NSCLC). Methods: Sequential trimodality PET/CT/MRI was performed in 36 patients referred with the clinical question of resectability assessment in NSCLC. PET/CT and PET/MR images including T 1 weighted sequence (T 1-Dixon) and respiration gated T 2 weighted sequence (T 2-Propeller) were evaluated for resectability-defining factors; i.e. longest diameter of the tumor, minimal tumor distance to the carina, mediastinal invasion, invasion of the carina, pleural infiltration, pericardial infiltration, diaphragm infiltration, presence of additional nodules. Results: There was no significant difference of maximal axial diameter measurements of the primary lung tumors and narrow limits of agreement in Bland–Altman analysis ranging from −11.1 mm to + 11.8 mm for T 2-Propeller and from −14.3 mm to + 13.8 mm for T 1-Dixon sequence. A high agreement of PET/MR with PET/CT for the different resectability-defining factors was observed (k from 0.769 to 1.000). There was an excellent agreement of T 2-Propeller sequence and CT for additional pulmonary nodule detection (k of 0.829 and 0.833), but only a moderate and good agreement using T 1-Dixon sequence (k of 0.484 and 0.722). Conclusion: In NSCLC the use of PET/MRI, including a dedicated pulmonary MR imaging protocol, provides a comparable diagnostic value for determination of tumor resectability compared to PET/CT. Advances in knowledge: Our findings suggest that whole body PET/MRI can safely be used for the local staging of NSCLC patients. Further studies are warranted to determine whether it is feasible to integrate an imaging sequence in a whole body PET/MRI setting with the potential advantage of detection of liver or brain metastases.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".