APTWI and stretch-exponential model DWI based 18F-FDG PET/MRI for differentiation of benign and malignant solitary pulmonary lesions

Motivation: Although most solitary pulmonary lesions (SPLs) are eventually determined to be benign, early differentiation between benign and malignant lesions remains crucial for effective patient management. Goal(s): This study aimed to perform simultaneous chest 18F-FDG PET, APTWI, MEM-DWI, and SEM-DWI scans in patients with SPLs to compare the differences in each parameter between the benign and malignant groups. Approach: The AUC was used to assess diagnostic efficacy. The Logistic regression analysis was used to identify independent predictors. Results: SUVmax, MTV, TLG, α, and MTRasym(3.5ppm) values were lower and ADC, DDC values were higher in benign SPLs than malignant SPLs (all P < 0.01). Impact: Multiparametric PET/MRI based on 18 F-FDG PET, MEM-DWI, SEM-DWI, and APTWI can effectively evaluate the characteristics of SPLs. The prediction model comprising SUVmax, ADC, and MTRasym (3.5 ppm) demonstrated superior diagnostic efficacy compared with individual parameters.