Predictive Value of FDG PET/CT, DWI and DCE-MRI Scans for Non-small Cell Lung Cancer Patients Receiving Chemotherapy

Prediction of Chemotherapy Response and Patient Prognosis in Non-small Cell Lung Cancer: Dynamic Contrast-enhanced MRI and Diffusion-weighted Imaging Versus Volume-based Parameter of 18F-FDG PET

In this prospective study, the investigators will evaluate and compare the usefulness of functional and volumetric informations obtained by 18F-FDG PET and MRI before and after the palliative chemotherapy with the aim of predicting tumor response and prognosis in patients with advanced Non-small Cell Lung Cancer (NSCLC).

Study cohort will undergo PET/CT and MRI scans prior to chemotherapy and after the first chemotherapy cycle. MRI scans include DCE-MRI and DWI. The following parameters will be calculated using these values:

1. Metabolic parameters on FDG-PET A. SUV change ratio (SCR) = SUVpost/SUVpre B. MTV change ratio (VCR) = MTVpost/pre C. TLG change ratio = SCR X VCR
2. Perfusion parameters on DCE-MRI A. Kep B. K-trans C. ve
3. Diffusion parameters on DWI A. Mean ADC B. fDM

Inclusion Criteria:

• Histologically proven NSCLC
• Newly diagnosed Stage stage IV
• Participant is being considered for the chemotherapy with EGFR TKI as a first line therapy
• At least one measurable primary or other intrathoracic lesion >= 2cm, according to RECIST
• Performance status of 0 to 2 on the ECOG scale
• Age 18 years or older
• Able to tolerable PET/CT and MRI imaging required by protocol
• Able to give study-specific informed consent

Exclusion Criteria:

• Pure bronchioloalveolar cell carcinoma histology
• Thoracic radiotherapy, lung surgery or chemotherapy within three months prior to inclusion in the study
• Poorly controlled diabetes
• Prior malignancy