Relationship between dynamic enhanced magnetic resonance imaging combined with DWI and malignant biological behavior of non-small cell lung cancer and the value of predicting prognosis

Objective: To investigate the relationship between dynamic enhanced magnetic resonance imaging(DCE-MRI) and diffusion-weighted magnetic resonance imaging (DWI) parameters and malignant biological be-havior of non-small cell lung cancer (NSCLC) and the value of combination in predicting the prognosis of NSCLC.Methods: A total of 120 patients with NSCLC in the First People’s Hospital of Lianyungang from Janu-ary 2020 to January 2022 were selected as the study group, and another 120 patients with benign pulmonary nod-ules in the same period and age group were selected as the control group, all of whom underwent DCE-MRI and DWI.The DCE-MRI parameters volume transfer constant (K^trans), rate constant (K_ep), percentage of extracellular space volume outside the blood vessel (V_e) and DWI parameters apparent diffusion coefficient (ADC) between the two groups were compared, the DCE-MRI and DWI parameters of patients with different malignant biological behaviors in the study group were com-pared, and the relationship between DCE-MRI and DWI parameters and malignant correlation of biological behaviors was analyzed.The clinical data, DCE-MRI and DWI parameters of patients with different prognosis in the research group after one year were compared, the predictive factors for poor prognosis were analyzed through Lasso regression and logistic regression, a Nomo-gram prediction model was constructed for poor prognosis based on the predictive factors, and the model was val-idated.Results: K^trans, K_ep, and V_e were higher and ADC was lower in the study group compared with the control group (P< 0.05); there were statistically significant differences in K^trans, K_ep, V_e and ADC among patients with dif-ferent tumor diameter, lymph node metastasis, clinical stage and Ki-67 index (P< 0.05).In the study group, K^trans, K_ep and V_e were positively correlated with tumor diameter, lymph node metastasis, clinical stage and Ki-67 index, while ADC was negatively correlated with tumor diameter, lymph node metastasis, clinical stage and Ki-67 index(all P< 0.05).There were statistically significant differences in tumor diameter, lymph node metastasis, clinical stage, Ki-67 index, K^trans, K_ep, V_e, and ADC in patients with poor prognosis compared with those with good progno-sis (P< 0.05).Six predictors were selected by Lasso regression: lymph node metastasis, clinical stage, K^trans, K_ep, V_e, and ADC, and logistic regression confirmed a significant correlation between lymph node metastasis, clinical stage, K^trans, K_ep, V_e, ADC and poor prognosis of NSCLC (P< 0.05).The Nomogram prediction model for poor prognosis of NSCLC patients was constructed based on the above factors, the AUC for predicting poor prognosis was 0.915, and the calibration and clinical decision curve (DCA) showed good consistency and clinical efficacy.Conclusion: DCE-MRI(K^trans, K_ep, V_e)and DWI(ADC)parameters are related to lymph node metastasis and clini-cal stage of patients.This Nomogram model for predicting poor prognosis constructed by the above factors has good predictive value.