Correlation between PD-L1 Expression of Non-Small Cell Lung Cancer and Data from IVIM-DWI Acquired during Magnetic Resonance of the Thorax: Preliminary Results

Abstract

This study aims to investigate the correlation between intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in magnetic resonance imaging (MRI) and programmed death-ligand 1 (PD-L1) expression in non-small cell lung cancer (NSCLC). Twenty-one patients diagnosed with stage III NSCLC from April 2021 to April 2022 were included. The tumors were distinguished into two groups: no PD-L1 expression (<1%), and positive PD-L1 expression (≥1%). Conventional MRI and IVIM-DWI sequences were acquired with a 1.5-T system. Both fixed-size ROIs and freehand segmentations of the tumors were evaluated, and the data were analyzed through a software using four different algorithms. The diffusion (D), pseudodiffusion (D*), and perfusion fraction (pf) were obtained. The correlation between IVIM parameters and PD-L1 expression was studied with Pearson correlation coefficient. The Wilcoxon–Mann–Whitney test was used to study IVIM parameter distributions in the two groups. Twelve patients (57%) had PD-L1 ≥1%, and 9 (43%) <1%. There was a statistically significant correlation between D* values and PD-L1 expression in images analyzed with algorithm 0, for fixed-size ROIs (189.2 ± 65.709 µm²/s × 104 in no PD-L1 expression vs. 122.0 ± 31.306 µm²/s × 104 in positive PD-L1 expression, p = 0.008). The values obtained with algorithms 1, 2, and 3 were not significantly different between the groups. The IVIM-DWI MRI parameter D* can reflect PD-L1 expression in NSCLC.

Amide Proton Transfer‐Weighted Imaging and Multiple Models Intravoxel Incoherent Motion‐Based 18F‐FDG PET/MRI for Predicting Progression‐Free Survival in Non‐Small Cell Lung Cancer

“…The D * value in this study was not only identified as one of the independent predictors of PFS but also showed an inverse trend with the risk of progression of NSCLC. This may be related to the fact that lesions with poorer prognoses tend to be more malignant, have tortuous vascular pathways, and thus have reduced average blood velocity 29 . However, some studies concluded that D * was not effective in assessing the prognosis of patients with NSCLC 27,30 .…”

“…This may be related to the fact that lesions with poorer prognoses tend to be more malignant, have tortuous vascular pathways, and thus have reduced average blood velocity. 29 However, some studies concluded that D* was not effective in assessing the prognosis of patients with NSCLC. 27,30 One possible explanation for these varying findings is that different types of treatments may significantly affect the outcome of perfusion-related parameters.…”

The Role of Native T1 and T2 Mapping Times in Identifying PD-L1 Expression and the Histological Subtype of NSCLCs

“…The application of multiparametric magnetic resonance imaging (MRI) to lung cancer analysis is a thoroughly explored field since MRI provides better tissue characterization compared to computed tomography (CT) while involving no exposure to ionizing radiation [ 7 , 8 ].…”