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Wucherpfennig L, Kauczor HU, Eichinger M, Wielpütz MO. [Magnetic resonance imaging of the lung : State of the art]. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:849-862. [PMID: 37851088 DOI: 10.1007/s00117-023-01229-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
Due to the low proton density of the lung parenchyma and the rapid signal decay at the air-tissue interfaces, for a long time the lungs were difficult to access using magnetic resonance imaging (MRI); however, technical advances could address most of these obstacles. Pulmonary alterations associated with tissue proliferation ("plus pathologies"), can now be detected with high diagnostic accuracy because of the locally increased proton density. Compared to computed tomography (CT), MRI provides a comprehensive range of functional imaging procedures (respiratory mechanics, perfusion and ventilation). In addition, as a radiation-free noninvasive examination modality, it enables repeated examinations for assessment of the course or monitoring of the effects of treatment, even in children. This article discusses the technical aspects, gives suggestions for protocols and explains the role of MRI of the lungs in the routine assessment of various diseases.
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Affiliation(s)
- Lena Wucherpfennig
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
- Translational Lung Research Center Heidelberg (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland
- Klinik für Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
| | - Hans-Ulrich Kauczor
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
- Translational Lung Research Center Heidelberg (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland
- Klinik für Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
| | - Monika Eichinger
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
- Translational Lung Research Center Heidelberg (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland
- Klinik für Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland
| | - Mark O Wielpütz
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland.
- Translational Lung Research Center Heidelberg (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland.
- Klinik für Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Röntgenstr. 1, 69126, Heidelberg, Deutschland.
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Bayraktaroğlu S, Çinkooğlu A, Tunakan Dalgıç C, Boğatekin G, Uysal FE, Ardeniz Ö. Comparison of chest computed tomography and 3-T magnetic resonance imaging results in patients with common variable immunodeficiency. Acta Radiol 2022; 64:1841-1850. [PMID: 36537132 DOI: 10.1177/02841851221144249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Patients with common variable immunodeficiency (CVID) have an increased incidence of pulmonary infections and require frequent follow-up computed tomography (CT) scans. Purpose To evaluate the diagnostic performance of 3-T magnetic resonance imaging (MRI) in patients with CVID. Material and Methods In this prospective study, 3-T MRI was performed in 20 patients with CVID. The patients were imaged with CT and MRI scans on the same day. The MRI protocol included a T2-weighted HASTE sequence (TR=1400 ms, TE=95 ms, slice thickness (ST)=3 mm), T2-weighted BLADE sequence (TR=5379 ms, TE=100 ms, ST=3 mm), and 3D VIBE sequence (TR=3.9 ms, TE=1.32 ms, ST=3 mm). Mediastinal and parenchymal changes were compared. A modified Bhalla scoring system was used in the evaluation of CT and MRI scans. Results A total of 17 (85%) patients had parenchymal abnormalities identified by CT or MRI. Similar findings were detected with CT and MRI in the assessment of the severity of bronchiectasis ( P=0.083), bronchial wall thickening ( P=0.157), and mucus plugging ( P=0.250). Consolidations were detected with both modalities in all patients. There was excellent concordance between the two modalities in the evaluation of nodules >5 mm (nodule size 5–10 mm, P=0.317; nodule size >10 mm, P=1). However, MRI failed to detect most of the small nodules (<5 mm). Conclusion 3-T MRI detected mediastinal and parenchymal alterations in patients with CVID and provided findings that correlated well with CT. Despite a few limitations, MRI is a well-suited radiation-free technique for patients requiring longitudinal imaging.
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Affiliation(s)
- Selen Bayraktaroğlu
- Department of Radiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Akın Çinkooğlu
- Department of Radiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Ceyda Tunakan Dalgıç
- Department of Allergy and Immunology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Gülhan Boğatekin
- Department of Allergy and Immunology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Funda Elmas Uysal
- Department of Respiratory Medicine, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Ömür Ardeniz
- Department of Allergy and Immunology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
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Wang L. Deep Learning Techniques to Diagnose Lung Cancer. Cancers (Basel) 2022; 14:cancers14225569. [PMID: 36428662 PMCID: PMC9688236 DOI: 10.3390/cancers14225569] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/11/2022] [Accepted: 11/11/2022] [Indexed: 11/15/2022] Open
Abstract
Medical imaging tools are essential in early-stage lung cancer diagnostics and the monitoring of lung cancer during treatment. Various medical imaging modalities, such as chest X-ray, magnetic resonance imaging, positron emission tomography, computed tomography, and molecular imaging techniques, have been extensively studied for lung cancer detection. These techniques have some limitations, including not classifying cancer images automatically, which is unsuitable for patients with other pathologies. It is urgently necessary to develop a sensitive and accurate approach to the early diagnosis of lung cancer. Deep learning is one of the fastest-growing topics in medical imaging, with rapidly emerging applications spanning medical image-based and textural data modalities. With the help of deep learning-based medical imaging tools, clinicians can detect and classify lung nodules more accurately and quickly. This paper presents the recent development of deep learning-based imaging techniques for early lung cancer detection.
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Affiliation(s)
- Lulu Wang
- Biomedical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
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Wang D, Qiu B, He H, Yin S, Peng K, Hu N, Guo J, Li Q, Chen N, Chu C, Liu F, Xie CM, Liu H. Tumor response evaluation by combined modalities of chest magnetic resonance imaging and computed tomography in locally advanced non-small cell lung cancer after concurrent chemoradiotherapy. Radiother Oncol 2022; 168:211-220. [DOI: 10.1016/j.radonc.2022.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022]
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Renz DM, Herrmann KH, Kraemer M, Boettcher J, Waginger M, Krueger PC, Pfeil A, Streitparth F, Kentouche K, Gruhn B, Mainz JG, Stenzel M, Teichgraeber UK, Reichenbach JR, Mentzel HJ. Ultrashort echo time MRI of the lung in children and adolescents: comparison with non-enhanced computed tomography and standard post-contrast T1w MRI sequences. Eur Radiol 2021; 32:1833-1842. [PMID: 34668994 PMCID: PMC8831263 DOI: 10.1007/s00330-021-08236-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/12/2021] [Accepted: 07/28/2021] [Indexed: 12/19/2022]
Abstract
Objectives To compare the diagnostic value of ultrashort echo time (UTE) magnetic resonance imaging (MRI) for the lung versus the gold standard computed tomography (CT) and two T1-weighted MRI sequences in children. Methods Twenty-three patients with proven oncologic disease (14 male, 9 female; mean age 9.0 + / − 5.4 years) received 35 low-dose CT and MRI examinations of the lung. The MRI protocol (1.5-T) included the following post-contrast sequences: two-dimensional (2D) incoherent gradient echo (GRE; acquisition with breath-hold), 3D volume interpolated GRE (breath-hold), and 3D high-resolution radial UTE sequences (performed during free-breathing). Images were evaluated by considering image quality as well as distinct diagnosis of pulmonary nodules and parenchymal areal opacities with consideration of sizes and characterisations. Results The UTE technique showed significantly higher overall image quality, better sharpness, and fewer artefacts than both other sequences. On CT, 110 pulmonary nodules with a mean diameter of 4.9 + / − 2.9 mm were detected. UTE imaging resulted in a significantly higher detection rate compared to both other sequences (p < 0.01): 76.4% (84 of 110 nodules) for UTE versus 60.9% (67 of 110) for incoherent GRE and 62.7% (69 of 110) for volume interpolated GRE sequences. The detection of parenchymal areal opacities by the UTE technique was also significantly higher with a rate of 93.3% (42 of 45 opacities) versus 77.8% (35 of 45) for 2D GRE and 80.0% (36 of 45) for 3D GRE sequences (p < 0.05). Conclusion The UTE technique for lung MRI is favourable in children with generally high diagnostic performance compared to standard T1-weighted sequences as well as CT. Key Points • Due to the possible acquisition during free-breathing of the patients, the UTE MRI sequence for the lung is favourable in children. • The UTE technique reaches higher overall image quality, better sharpness, and lower artefacts, but not higher contrast compared to standard post-contrast T1-weighted sequences. • In comparison to the gold standard chest CT, the detection rate of small pulmonary nodules small nodules ≤ 4 mm and subtle parenchymal areal opacities is higher with the UTE imaging than standard T1-weighted sequences. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08236-7.
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Affiliation(s)
- Diane M Renz
- Department of Paediatric Radiology, Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Karl-Heinz Herrmann
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Martin Kraemer
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | | | - Matthias Waginger
- Department of Paediatric Radiology, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Paul-Christian Krueger
- Department of Paediatric Radiology, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Alexander Pfeil
- Department of Internal Medicine III, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Florian Streitparth
- Department of Radiology, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Karim Kentouche
- Department of Paediatrics, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Bernd Gruhn
- Department of Paediatrics, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Jochen G Mainz
- Department of Paediatric Pulmonology and Cystic Fibrosis, Brandenburg Medical School, University Hospital, Brandenburg, Germany
| | - Martin Stenzel
- Department of Paediatric Radiology, Children´s Hospital, Cologne, Germany
| | - Ulf K Teichgraeber
- Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Juergen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Hans-Joachim Mentzel
- Department of Paediatric Radiology, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
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Balasch A, Metze P, Stumpf K, Beer M, Büttner SM, Rottbauer W, Speidel T, Rasche V. 2D
Ultrashort Echo‐Time Functional Lung Imaging. J Magn Reson Imaging 2020; 52:1637-1644. [DOI: 10.1002/jmri.27269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Anke Balasch
- Department of Internal Medicine II Ulm University Medical Centre Ulm Germany
| | - Patrick Metze
- Department of Internal Medicine II Ulm University Medical Centre Ulm Germany
| | - Kilian Stumpf
- Department of Internal Medicine II Ulm University Medical Centre Ulm Germany
| | - Meinrad Beer
- Department of Radiology Ulm University Medical Centre Ulm Germany
| | | | - Wolfgang Rottbauer
- Department of Internal Medicine II Ulm University Medical Centre Ulm Germany
| | - Tobias Speidel
- Core‐Facility Small Animal Imaging, Medical Faculty Ulm University Germany
| | - Volker Rasche
- Department of Internal Medicine II Ulm University Medical Centre Ulm Germany
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Rana P, Sodhi KS, Bhatia A, Saxena AK, Suri D, Singh S. Diagnostic accuracy of 3-T lung magnetic resonance imaging in human immunodeficiency virus-positive children. Pediatr Radiol 2020; 50:38-45. [PMID: 31520121 DOI: 10.1007/s00247-019-04523-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/11/2019] [Accepted: 09/02/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND More than 70% of human immunodeficiency virus (HIV)-positive children sustain respiratory diseases in their lifetime. Imaging plays an important role in establishing early and correct diagnosis. OBJECTIVE To evaluate the diagnostic accuracy of 3-Tesla (T) thorax MRI in HIV-positive children, using chest CT as the gold standard. MATERIALS AND METHODS We included 25 children with confirmed HIV-positive status and pulmonary complaints who were referred for chest CT. All children had 3-T thorax MRI using T2-W turbo spin-echo sequence, steady-state free precession gradient echo sequence, T2-W turbo spin-echo MultiVane XD sequence, and T1-weighted modified Dixon sequences. We evaluated the images for various pulmonary and mediastinal findings and calculated the sensitivity and specificity of 3-T thoracic MRI. RESULTS Sensitivity of 3-T MRI was 100% for detecting nodules >4 mm (95% confidence interval [CI] 66.3-100%), pleural effusion (CI 29.2-100%) and lymphadenopathy (CI 81.5-100%). It demonstrated a specificity of 100% for nodules >4 mm (CI 79.4-100%), pleural effusion (CI 84.6-100%) and lymphadenopathy (CI 59-100%). For consolidation/collapse, sensitivity and specificity were 93.8% (CI 69.8-99.8%) and 88.9% (CI 51.8-99.7%), respectively. The sensitivity and specificity for detecting bronchiectasis were 75% (CI 42.8-94.5%) and 100% (CI 75.3-100%), respectively, while for ground-glass opacity, sensitivity and specificity were 75% (CI 34.9-96.8%) and 94.1% (CI 71.3-99.9%), respectively. Nodules <4 mm were not well detected on MRI, with sensitivity of 35% (CI 15.4-59.2%). CONCLUSION Thoracic MRI at 3 T demonstrates a high sensitivity and specificity for detecting nodules >4 mm, effusion and lymphadenopathy in HIV-positive children.
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Affiliation(s)
- Pratyaksha Rana
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Kushaljit Singh Sodhi
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India.
| | - Anmol Bhatia
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Akshay Kumar Saxena
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Deepti Suri
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
| | - Surjit Singh
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India
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Bin Saeedan M, Alabdulkarim FM, Aloufi FF, Alghofaily KA, Parkar N, Ghosh S. Check the chest: review of chest findings on abdominal MRI. Clin Imaging 2019; 59:68-77. [PMID: 31760280 DOI: 10.1016/j.clinimag.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/11/2019] [Accepted: 10/03/2019] [Indexed: 01/14/2023]
Abstract
Magnetic resonance imaging (MRI) of the abdomen may include lower chest findings which may be overlooked or misinterpreted due to their location outside the area of main exam focus or lack of familiarity with the image appearance of these findings. This article will review the utility of abdominal MRI sequences to diagnose lower chest pathology while providing a systematic pictorial review of imaging findings in the lungs, pleura, mediastinum and chest wall. We will discuss the MRI appearance of lung nodules and masses, lung infiltrates, pulmonary infarction, pulmonary embolism, empyema, pleural effusions and thickening, mediastinal lesions and lymphadenopathy, cardiac thrombus and masses, and breast lesions. The purpose of this article is to increase awareness to the diagnostic advantages of abdominal MRI sequences for lower chest findings and encourage abdominal MRI readers to meticulous scrutinize the lower chest for concomitant pathology.
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Affiliation(s)
- Mnahi Bin Saeedan
- King Faisal Specialist Hospital and Research Center, Department of Radiology, Riyadh, Saudi Arabia.
| | | | - Faisal Fahad Aloufi
- King Faisal Specialist Hospital and Research Center, Department of Radiology, Riyadh, Saudi Arabia
| | - Khalefa Ali Alghofaily
- Al-Qassim University, College of Medicine, Medical Imaging Department, Buraydah, Saudi Arabia
| | - Nadeem Parkar
- Section of Thoracic Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Subha Ghosh
- Section of Thoracic Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
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A Prospective Study of Magnetic Resonance Imaging Assessment of Post-radiation Changes Following Stereotactic Body Radiation Therapy for Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2019; 31:720-727. [DOI: 10.1016/j.clon.2019.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 04/09/2019] [Accepted: 04/18/2019] [Indexed: 12/25/2022]
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Kapur S, Jana M, Gupta L, Bhalla AS, Naranje P, Gupta AK. Chest MRI Using Multivane-XD, a Novel T2-Weighted Free Breathing MR Sequence. Curr Probl Diagn Radiol 2019; 50:41-47. [PMID: 31383474 DOI: 10.1067/j.cpradiol.2019.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare image quality of free-breathing T2-weighted MultiVane-XD (MVXD) sequence (non-Cartesian k-space filling using radial rectangular blades) with conventional MR sequences (short tau inversion recovery [STIR],balanced true field echo [BTFE], T1 in phase fast field echo [T1 FFE], and T1-fat saturated postgadolinium [T1PG]) in MR imaging of chest. MATERIALS AND METHODS Twenty-one patients (10 men and 11 women) underwent chest MRI including T2W MVXD, STIR, BTFE (18/21), T1 FFE, T1PG (10/21) sequences at 1.5 T. Two reviewers (A.S.B and M.J. with 20 and 10 years of experience in pulmonary imaging, respectively) evaluated each sequence with respect to overall image quality, image sharpness, definition of mediastinal vessels including the aorta, pulmonary arteries, superior vena cava, intrapulmonary vessels; trachea, main bronchi, intrapulmonary airways; lung-mediastinal interface, pulmonary lesion detection, and artefacts in the upper, middle, and lower third of chest using 5-point scales. No sedation was given. Pairwise comparisons between T2W MVXD and the 4 conventional sequences were made using unpaired student's t test. RESULTS Mean age of patients was 30.67 years (range: 6-60 years). T2 MVXD showed significantly better overall image quality and sharpness than STIR, T1 FFE, and T1PG (P < 0.01) while it was comparable to BTFE. Mediastinal vessels were significantly better visualized on T2 MVXD as compared to STIR and T1 (P < 0.003). However, BTFE and T1PG were superior to T2 MVXD for visualization of great vessels, SVC, and intrapulmonary vessels (P < 0.01). Visualization of trachea, major bronchi, intrapulmonary airways as well as intrapulmonary lesion detection was significantly better on T2 MVXD images in comparison to any of the other 4 sequences (P < 0.03). Intrapulmonary artifacts were significantly lesser in BTFE images as compared to T2 MVXD (P < 0.01). No significant difference was found between the severity of intrapulmonary artifacts in other MR sequences as compared to T2 MVXD. CONCLUSIONS By virtue of its better overall image quality, sharpness, superior visualization of mediastinal airways, and lesion detection, T2 MultiVane-XD promises to be a robust addition in the armamentarium of thoracic radiologists.
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Affiliation(s)
- Savinay Kapur
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Lalit Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ashu S Bhalla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Arun K Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
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Chassagnon G, Martin C, Ben Hassen W, Freche G, Bennani S, Morel B, Revel MP. High-resolution lung MRI with Ultrashort-TE: 1.5 or 3 Tesla? Magn Reson Imaging 2019; 61:97-103. [PMID: 31051201 DOI: 10.1016/j.mri.2019.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/15/2019] [Accepted: 04/29/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE To assess the influence of magnetic field strength and additionally of acquisition and reconstruction parameters on the quality of high-resolution lung MRI, using a prototype Ultrashort-TE (UTE) sequence. MATERIALS AND METHODS This prospective study received ethical approval and all participants provided written informed consent. From January to February 2018, images were obtained in 10 healthy volunteers at 1.5 T and 3 T with a prototypical free-breathing UTE spiral 3D-GRE sequence with volumetric interpolation (VIBE) sequence and near-millimeter resolution. Five sequences were acquired to assess the effects of magnetic field strength (1.5 vs 3 T), voxel resolution (1.2 vs 1.0mm3), number of spiral interleaves (464 vs 264) and iterative reconstruction (iterative self-consistent parallel imaging reconstruction [SPIRiT] versus Non-Uniform Fourier Transform [NUFFT]) on image quality. Image quality was assessed by two independent observers. They evaluated the proportion of detected airways from the trachea down to the subsegmental level and placed ROI in the lung parenchyma, airways and vessels to calculate signal-to noise (SNR) and contrast-to-noise (CNR) ratios. Continuous variables were expressed as mean ± standard deviation and were compared by t-test. RESULTS Nearly complete visualization of the segmental bronchi (94 ± 12 to 99 ± 3%) was obtained with all sequences. Acquisition at 3 T (p < 0.001), use of a fewer spiral interleaves (p < 0.001) and NUFFT reconstruction (p < 0.001) all resulted in a significantly lower visibility of the subsegmental bronchi, while a smaller voxel size improved their visibility (p = 0.001). SNR and CNR were significantly lower at 3 T (140.2 ± 19.9 vs 190.2 ± 34.8, p < 0.001; and 5.7 ± 2.4vs 10.8 ± 2.8, p < 0.001, respectively). CONCLUSIONS Using equivalent acquisition and reconstruction parameters, image quality was lower at 3 T than at 1.5 T with decreased visibility of the subsegmental bronchi and lower SNR and CNR values.
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Affiliation(s)
- Guillaume Chassagnon
- Radiology Department, Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190, Gif-sur-Yvette, France
| | - Charlotte Martin
- Radiology Department, Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Wadie Ben Hassen
- Siemens Healthineers France, 40 avenue des fruitiers, 93210 Saint-Denis, France
| | - Gael Freche
- Radiology Department, Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Souhail Bennani
- Radiology Department, Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Baptiste Morel
- Radiology Department, Hopital Clocheville, CHU Tours, Université François Rabelais, 49 Boulevard Béranger, 37000 Tours, France
| | - Marie-Pierre Revel
- Radiology Department, Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France.
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Raptis CA, Ludwig DR, Hammer MM, Luna A, Broncano J, Henry TS, Bhalla S, Ackman JB. Building blocks for thoracic MRI: Challenges, sequences, and protocol design. J Magn Reson Imaging 2019; 50:682-701. [PMID: 30779459 DOI: 10.1002/jmri.26677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/18/2019] [Accepted: 01/19/2019] [Indexed: 12/19/2022] Open
Abstract
Thoracic MRI presents important and unique challenges. Decreased proton density in the lung in combination with respiratory and cardiac motion can degrade image quality and render poorly executed sequences uninterpretable. Despite these challenges, thoracic MRI has an important clinical role, both as a problem-solving tool and in an increasing array of clinical indications. Advances in scanner and sequence design have also helped to drive this development, presenting the radiologist with improved techniques for thoracic MRI. Given this evolving landscape, radiologists must be familiar with what thoracic MR has to offer. The first step in developing an effective thoracic MRI practice requires the creation of efficient and malleable protocols that can answer clinical questions. To do this, radiologists must have a working knowledge of the MR sequences that are used in the thorax, many of which have been adapted from use elsewhere in the body. These sequences can be broadly divided into three categories: traditional/anatomic, functional, and cine based. Traditional/anatomic sequences allow for the depiction of anatomy and pathologic processes with the ability for characterization of signal intensity and contrast enhancement. Functional sequences, including diffusion-weighted imaging, and high temporal resolution dynamic contrast enhancement, allow for the noninvasive measurement of tissue-specific parameters. Cine-based sequences can depict the motion of structures in the thorax, either with retrospective ECG gating or in real time. The purpose of this article is to review these categories, the building block sequences that comprise them, and identify basic questions that should be considered in thoracic MRI protocol design. Level of Evidence: 5 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:682-701.
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Affiliation(s)
| | - Daniel R Ludwig
- Mallinckrodt Institute of Radiology, St. Louis, Missouri, USA
| | - Mark M Hammer
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Antonio Luna
- Health Time, Clinica Las Nieves, Jaen, Spain.,University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jordi Broncano
- Health Time, Hospital de la Cruz Roja and San Juan de Dios, Cordoba, Spain
| | - Travis S Henry
- University of California-San Francisco, San Francisco, California, USA
| | - Sanjeev Bhalla
- Mallinckrodt Institute of Radiology, St. Louis, Missouri, USA
| | - Jeanne B Ackman
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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van Sörnsen de Koste JR, Palacios MA, Bruynzeel AME, Slotman BJ, Senan S, Lagerwaard FJ. MR-guided Gated Stereotactic Radiation Therapy Delivery for Lung, Adrenal, and Pancreatic Tumors: A Geometric Analysis. Int J Radiat Oncol Biol Phys 2018; 102:858-866. [PMID: 30061007 DOI: 10.1016/j.ijrobp.2018.05.048] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 12/11/2017] [Accepted: 05/16/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE We implemented magnetic resonance-guided breath-hold stereotactic body radiation therapy in combination with visual feedback using the MRIdian system. Both accuracy of gated delivery and reproducibility of tumor positions were studied. METHODS AND MATERIALS Tumor tracking is realized through repeated magnetic resonance imaging in a single sagittal plane at 4 frames per second with deformable image registration. An in-room monitor allowed visualization of the tracked gross tumor volume (GTV) contour and the planning target volume (PTV) (GTV + 3 mm), which was the gating boundary. For each delivery, a predefined threshold-region of interest percentage (ROI%) allows a percentage of GTV area to be outside the gating boundary before a beam-hold is triggered. Accuracy of gated delivery and tumor position reproducibility during breath-holds was analyzed for 15 patients (87 fractions) with lung, adrenal, and pancreas tumors. For each fraction, we analyzed (1) reproducibility of system-tracked GTV centroid position within the PTV; (2) geometric coverage of GTV area within the PTV; (3) treatment duty cycle efficiency; (4) effects of threshold ROI% settings on treatment duty cycle efficiency and GTV area coverage; and (5) beam-off latency effect on mean GTV coverage. RESULTS For lung, adrenal, and pancreatic tumors, grouped 5th to 95th percentile distributions of GTV centroid positions in the dorsoventral direction, relative to PTV-center of mass (COM), were, respectively, -3.3 mm to 2.8 mm, -2.5 mm to 3.7 mm, and -4.4 mm to 2.9 mm. Corresponding distributions in the craniocaudal direction were -2.6 mm to 4.6 mm, -4.1 mm to 4.4 mm, and -4.4 mm to 4.5 mm, respectively. Mean GTV areas encompassed during beam-on for all fractions were 94.6%, 94.3%, and 95.3% for lung, adrenal, and pancreas tumors, respectively. Mean treatment duty cycle efficiency ranged from 67% to 87% for these tumors. Use of higher threshold-ROI% resulted in increased duty cycle efficiency, at the cost of a small decrease in GTV area coverage. The beam-off latency had a marginal impact on the GTV coverage. CONCLUSIONS Gated stereotactic body radiation therapy delivery during breath-hold, real-time magnetic resonance guidance resulted in at least 95% geometric GTV coverage in lung, adrenal, and pancreatic tumors.
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Affiliation(s)
| | - Miguel A Palacios
- Department of Radiation Oncology, VU medical center, Amsterdam, The Netherlands
| | - Anna M E Bruynzeel
- Department of Radiation Oncology, VU medical center, Amsterdam, The Netherlands
| | - Ben J Slotman
- Department of Radiation Oncology, VU medical center, Amsterdam, The Netherlands
| | - Suresh Senan
- Department of Radiation Oncology, VU medical center, Amsterdam, The Netherlands
| | - Frank J Lagerwaard
- Department of Radiation Oncology, VU medical center, Amsterdam, The Netherlands
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Wang L. Screening and Biosensor-Based Approaches for Lung Cancer Detection. SENSORS (BASEL, SWITZERLAND) 2017; 17:E2420. [PMID: 29065541 PMCID: PMC5677261 DOI: 10.3390/s17102420] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 02/07/2023]
Abstract
Early diagnosis of lung cancer helps to reduce the cancer death rate significantly. Over the years, investigators worldwide have extensively investigated many screening modalities for lung cancer detection, including computerized tomography, chest X-ray, positron emission tomography, sputum cytology, magnetic resonance imaging and biopsy. However, these techniques are not suitable for patients with other pathologies. Developing a rapid and sensitive technique for early diagnosis of lung cancer is urgently needed. Biosensor-based techniques have been recently recommended as a rapid and cost-effective tool for early diagnosis of lung tumor markers. This paper reviews the recent development in screening and biosensor-based techniques for early lung cancer detection.
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Affiliation(s)
- Lulu Wang
- School of Instrument Science and Opto-electronics Engineering, Hefei University of Technology, Hefei 230009, China.
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland 1142, New Zealand.
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Scholz O, Denecke T, Böttcher J, Schwarz C, Mentzel HJ, Streitparth F, Maurer MH, Pfeil A, Huppertz A, Mehl A, Staab D, Hamm B, Renz DM. MRI of cystic fibrosis lung manifestations: sequence evaluation and clinical outcome analysis. Clin Radiol 2017; 72:754-763. [PMID: 28545684 DOI: 10.1016/j.crad.2017.03.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/19/2017] [Accepted: 03/20/2017] [Indexed: 11/17/2022]
Abstract
AIM To evaluate different magnetic resonance imaging (MRI) sequences for diagnosis of pulmonary manifestations of cystic fibrosis (CF) in comparison to chest computed tomography (CT), including an extended outcome analysis. MATERIALS AND METHODS Twenty-eight patients with CF (15 male, 13 female, mean age 30.5±9.4 years) underwent CT and MRI of the lung. MRI (1.5 T) included different T2- and T1-weighted sequences: breath-hold HASTE (half Fourier acquisition single shot turbo spin echo) and VIBE (volumetric interpolated breath-hold examination, before and after contrast medium administration) sequences and respiratory-triggered PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) sequences with and without fat signal suppression, and perfusion imaging. CT and MRI images were evaluated by the modified Helbich and the Eichinger scoring systems. The clinical follow-up analysis assessed pulmonary exacerbations within 24 months. RESULTS The highest concordance to CT was achieved for the PROPELLER sequences without fat signal suppression (concordance correlation coefficient CCC of the overall modified Helbich score 0.93 and of the overall Eichinger score 0.93). The other sequences had the following concordance: PROPELLER with fat signal suppression (CCCs 0.91 and 0.92), HASTE (CCCs 0.87 and 0.89), VIBE (CCCs 0.84 and 0.85) sequences. In the outcome analysis, the combined MRI analysis of all five sequences and a specific MRI protocol (PROPELLER without fast signal suppression, VIBE sequences, perfusion imaging) reached similar correlations to the number of pulmonary exacerbations as the CT examinations. CONCLUSION An optimum lung MRI protocol in patients with CF consists of PROPELLER sequences without fat signal suppression, VIBE sequences, and lung perfusion analysis to enable high diagnostic efficacy and outcome prediction.
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Affiliation(s)
- O Scholz
- Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - T Denecke
- Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - J Böttcher
- Institute of Diagnostic and Interventional Radiology, SRH Clinic Gera, Str. des Friedens 122, 07548 Gera, Germany
| | - C Schwarz
- Division of Pulmonology and Immunology, Department of Pediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - H-J Mentzel
- Institute of Diagnostic and Interventional Radiology, Department of Pediatric Radiology, Friedrich-Schiller-University, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany
| | - F Streitparth
- Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - M H Maurer
- Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - A Pfeil
- Department of Internal Medicine III, Friedrich-Schiller-University, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany
| | - A Huppertz
- Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - A Mehl
- Division of Pulmonology and Immunology, Department of Pediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - D Staab
- Division of Pulmonology and Immunology, Department of Pediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - B Hamm
- Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - D M Renz
- Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany; Institute of Diagnostic and Interventional Radiology, Department of Pediatric Radiology, Friedrich-Schiller-University, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany.
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Kumar S, Rai R, Moses D, Choong C, Holloway L, Vinod SK, Liney G. MRI in radiotherapy for lung cancer: A free-breathing protocol at 3T. Pract Radiat Oncol 2017; 7:e175-e183. [DOI: 10.1016/j.prro.2016.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/12/2016] [Accepted: 10/14/2016] [Indexed: 01/22/2023]
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Arai TJ, Nofiele J, Madhuranthakam AJ, Yuan Q, Pedrosa I, Chopra R, Sawant A. Characterizing spatiotemporal information loss in sparse-sampling-based dynamic MRI for monitoring respiration-induced tumor motion in radiotherapy. Med Phys 2017; 43:2807-2820. [PMID: 27277029 DOI: 10.1118/1.4948684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Sparse-sampling and reconstruction techniques represent an attractive strategy to achieve faster image acquisition speeds, while maintaining adequate spatial resolution and signal-to-noise ratio in rapid magnetic resonance imaging (MRI). The authors investigate the use of one such sequence, broad-use linear acquisition speed-up technique (k-t BLAST) in monitoring tumor motion for thoracic and abdominal radiotherapy and examine the potential trade-off between increased sparsification (to increase imaging speed) and the potential loss of "true" information due to greater reliance on a priori information. METHODS Lung tumor motion trajectories in the superior-inferior direction, previously recorded from ten lung cancer patients, were replayed using a motion phantom module driven by an MRI-compatible motion platform. Eppendorf test tubes filled with water which serve as fiducial markers were placed in the phantom. The modeled rigid and deformable motions were collected in a coronal image slice using balanced fast field echo in conjunction with k-t BLAST. Root mean square (RMS) error was used as a metric of spatial accuracy as measured trajectories were compared to input data. The loss of spatial information was characterized for progressively increasing acceleration factor from 1 to 16; the resultant sampling frequency was increased approximately from 2.5 to 19 Hz when the principal direction of the motion was set along frequency encoding direction. In addition to the phantom study, respiration-induced tumor motions were captured from two patients (kidney tumor and lung tumor) at 13 Hz over 49 s to demonstrate the impact of high speed motion monitoring over multiple breathing cycles. For each subject, the authors compared the tumor centroid trajectory as well as the deformable motion during free breathing. RESULTS In the rigid and deformable phantom studies, the RMS error of target tracking at the acquisition speed of 19 Hz was approximately 0.3-0.4 mm, which was smaller than the reconstructed pixel resolution of 0.67 mm. In the patient study, the dynamic 2D MRI enabled the monitoring of cycle-to-cycle respiratory variability present in the tumor position. It was seen that the range of centroid motion as well as the area covered due to target motion during each individual respiratory cycle was underestimated compared to the entire motion range observed over multiple breathing cycles. CONCLUSIONS The authors' initial results demonstrate that sparse-sampling- and reconstruction-based dynamic MRI can be used to achieve adequate image acquisition speeds without significant information loss for the task of radiotherapy guidance. Such monitoring can yield spatial and temporal information superior to conventional offline and online motion capture methods used in thoracic and abdominal radiotherapy.
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Affiliation(s)
- Tatsuya J Arai
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas 75390
| | - Joris Nofiele
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390
| | - Ananth J Madhuranthakam
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390 and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas 75390
| | - Qing Yuan
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390
| | - Ivan Pedrosa
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390 and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas 75390
| | - Rajiv Chopra
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390 and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas 75390
| | - Amit Sawant
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas 75390; Department of Radiology, UT Southwestern Medical Center, Dallas, Texas 75390; and Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, 21201
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Ozcan HN, Gormez A, Ozsurekci Y, Karakaya J, Oguz B, Unal S, Cetin M, Ceyhan M, Haliloglu M. Magnetic resonance imaging of pulmonary infection in immunocompromised children: comparison with multidetector computed tomography. Pediatr Radiol 2017; 47:146-153. [PMID: 27796469 DOI: 10.1007/s00247-016-3729-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 08/28/2016] [Accepted: 10/07/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Computed tomography (CT) is commonly used to detect pulmonary infection in immunocompromised children. OBJECTIVE To compare MRI and multidetector CT findings of pulmonary abnormalities in immunocompromised children. MATERIALS AND METHODS Seventeen neutropaenic children (6 girls; ages 2-18 years) were included. Non-contrast-enhanced CT was performed with a 64-detector CT scanner. Axial and coronal non-enhanced thoracic MRI was performed using a 1.5-T scanner within 24 h of the CT examination (true fast imaging with steady-state free precession, fat-saturated T2-weighted turbo spin echo with motion correction, T2-weighted half-Fourier single-shot turbo spin echo [HASTE], fat-saturated T1-weighted spoiled gradient echo). Pulmonary abnormalities (nodules, consolidations, ground glass opacities, atelectasis, pleural effusion and lymph nodes) were evaluated and compared among MRI sequences and between MRI and CT. The relationship between MRI sequences and nodule sizes was examined by chi- square test. RESULTS Of 256 CT lesions, 207 (81%, 95% confidence interval [CI] 76-85%) were detected at MRI. Of 202 CT-detected nodules, 157 (78%, 95% CI 71-83%) were seen at motion-corrected MRI. Of the 1-5-mm nodules, 69% were detected by motion-corrected T2-weighted MRI and 38% by HASTE MRI. CONCLUSION Sensitivity of MRI (both axial fat-saturated T2-weighted turbo spin echo with variable phase encoding directions (BLADE) images and HASTE sequences) to detect pulmonary abnormalities is promising.
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Affiliation(s)
- H Nursun Ozcan
- Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Ayşegul Gormez
- Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Yasemin Ozsurekci
- Department of Pediatric Infectious Disease, Hacettepe University School of Medicine, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Berna Oguz
- Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Sule Unal
- Department of Pediatric Hematology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mualla Cetin
- Department of Pediatric Hematology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mehmet Ceyhan
- Department of Pediatric Infectious Disease, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mithat Haliloglu
- Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey.
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Biederer J. General Requirements of MRI of the Lung and Suggested Standard Protocol. MRI OF THE LUNG 2017. [DOI: 10.1007/174_2017_98] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Screening for lung cancer: Does MRI have a role? Eur J Radiol 2017; 86:353-360. [DOI: 10.1016/j.ejrad.2016.09.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/15/2016] [Indexed: 12/17/2022]
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Schwenzer NF, Seith F, Gatidis S, Brendle C, Schmidt H, Pfannenberg CA, laFougère C, Nikolaou K, Schraml C. Diagnosing Lung Nodules on Oncologic MR/PET Imaging: Comparison of Fast T1-Weighted Sequences and Influence of Image Acquisition in Inspiration and Expiration Breath-Hold. Korean J Radiol 2016; 17:684-94. [PMID: 27587957 PMCID: PMC5007395 DOI: 10.3348/kjr.2016.17.5.684] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 04/26/2016] [Indexed: 12/21/2022] Open
Abstract
Objective First, to investigate the diagnostic performance of fast T1-weighted sequences for lung nodule evaluation in oncologic magnetic resonance (MR)/positron emission tomography (PET). Second, to evaluate the influence of image acquisition in inspiration and expiration breath-hold on diagnostic performance. Materials and Methods The study was approved by the local Institutional Review Board. PET/CT and MR/PET of 44 cancer patients were evaluated by 2 readers. PET/CT included lung computed tomography (CT) scans in inspiration and expiration (CTin, CTex). MR/PET included Dixon sequence for attenuation correction and fast T1-weighted volumetric interpolated breath-hold examination (VIBE) sequences (volume interpolated breath-hold examination acquired in inspiration [VIBEin], volume interpolated breath-hold examination acquired in expiration [VIBEex]). Diagnostic performance was analyzed for lesion-, lobe-, and size-dependence. Diagnostic confidence was evaluated (4-point Likert-scale; 1 = high). Jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed. Results Seventy-six pulmonary lesions were evaluated. Lesion-based detection rates were: CTex, 77.6%; VIBEin, 53.3%; VIBEex, 51.3%; and Dixon, 22.4%. Lobe-based detection rates were: CTex, 89.6%; VIBEin, 58.3%; VIBEex, 60.4%; and Dixon, 31.3%. In contrast to CT, inspiration versus expiration did not alter diagnostic performance in VIBE sequences. Diagnostic confidence was best for VIBEin and CTex and decreased in VIBEex and Dixon (1.2 ± 0.6; 1.2 ± 0.7; 1.5 ± 0.9; 1.7 ± 1.1, respectively). The JAFROC figure-of-merit of Dixon was significantly lower. All patients with malignant lesions were identified by CTex, VIBEin, and VIBEex, while 3 patients were false-negative in Dixon. Conclusion Fast T1-weighted VIBE sequences allow for identification of patients with malignant pulmonary lesions. The Dixon sequence is not recommended for lung nodule evaluation in oncologic MR/PET patients. In contrast to CT, inspiration versus expiratory breath-hold in VIBE sequences was less crucial for lung nodule evaluation but was important for diagnostic confidence.
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Affiliation(s)
- Nina F Schwenzer
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Ferdinand Seith
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Sergios Gatidis
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Cornelia Brendle
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany.; Department of Diagnostic and Interventional Neuroradiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Holger Schmidt
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Christina A Pfannenberg
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Christian laFougère
- Department of Nuclear Medicine, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
| | - Christina Schraml
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany
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Ahlawat S, Morris C, Fayad LM. Three-dimensional volumetric MRI with isotropic resolution: improved speed of acquisition, spatial resolution and assessment of lesion conspicuity in patients with recurrent soft tissue sarcoma. Skeletal Radiol 2016; 45:645-52. [PMID: 26897528 DOI: 10.1007/s00256-016-2348-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/31/2016] [Accepted: 02/04/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND To assess the acquisition speed, lesion conspicuity, and inter-observer agreement associated with volumetric T(1)-weighted MR sequences with isotropic resolution for detecting recurrent soft-tissue sarcoma (STS). METHODS Fifteen subjects with histologically proven recurrent STS underwent MRI, including axial and coronal T(1)-weighted spin echo (T(1)-WSE) (5-mm slice thickness) and coronal 3D volumetric T(1)-weighted (fat-suppressed, volume-interpolated, breath-hold examination; repetition time/echo time, 3.7/1.4 ms; flip angle, 9.5°; 1-mm slice thickness) sequences before and after intravenous contrast administration. Subtraction imaging and multiplanar reformations (MPRs) were performed. Acquisition times for T(1)-WSE in two planes and 3D sequences were reported. Two radiologists reviewed images for quality (>50 % artifacts, 25-50 % artifacts, <25 % artifacts, and no substantial artifacts), lesion conspicuity, contrast-to-noise ratio (CNR(muscle)), recurrence size, and recurrence-to-joint distance. Descriptive and intraclass correlation (ICC) statistics are given. RESULTS Mean acquisition times were significantly less for 3D imaging compared with 2-plane T(1)-WSE (183.6 vs 342.6 s; P = 0.012). Image quality was rated as having no substantial artifacts in 13/15 and <25 % artifacts in 2/15. Lesion conspicuity was significantly improved for subtracted versus unsubtracted images (CNR(muscle), 100 ± 138 vs 181 ± 199; P = 0.05). Mean recurrent lesion size was 2.5 cm (range, 0.7-5.7 cm), and measurements on 3D sequences offered excellent interobserver agreement (ICC, 0.98 for lesion size and 0.96 for recurrence-to-joint distance with MPR views). CONCLUSION Three-dimensional volumetric sequences offer faster acquisition times, higher spatial resolution, and MPR capability compared with 2D T(1)-WSE for postcontrast imaging. Subtraction imaging provides higher lesion conspicuity for detecting recurrent STS in skeletal muscle, with excellent interobserver agreement between readers.
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Affiliation(s)
- Shivani Ahlawat
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
| | - Carol Morris
- Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA.,Department of Oncology, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.,Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA.,Department of Oncology, The Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD, 21287, USA
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Dournes G, Menut F, Macey J, Fayon M, Chateil JF, Salel M, Corneloup O, Montaudon M, Berger P, Laurent F. Lung morphology assessment of cystic fibrosis using MRI with ultra-short echo time at submillimeter spatial resolution. Eur Radiol 2016; 26:3811-3820. [PMID: 26843010 DOI: 10.1007/s00330-016-4218-5] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 12/29/2015] [Accepted: 01/13/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES We hypothesized that non-contrast-enhanced PETRA (pointwise encoding time reduction with radial acquisition) MR (magnetic resonance) sequencing could be an alternative to unenhanced computed tomography (CT) in assessing cystic fibrosis (CF) lung structural alterations, as well as compared agreements and concordances with those of conventional T1-weighted and T2-weighted sequences. MATERIAL AND METHODS Thirty consecutive CF patients completed both CT and MRI the same day. No contrast injection was used. Agreement in identifying structural alterations was evaluated at the segmental level using a kappa test. Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to assess concordances and reproducibility in Helbich-Bhalla disease severity scoring. RESULTS Agreement between PETRA and CT was higher than that of T1- or T2-weighted sequences, notably in assessing the segmental presence of bronchiectasis (Kappa = 0.83; 0.51; 0.49, respectively). The concordance in Helbich-Bhalla scores was very good using PETRA (ICC = 0.97), independently from its magnitude (mean difference (MD) = -0.3 [-2.8; 2.2]), whereas scoring was underestimated using both conventional T1 and T2 sequences (MD = -3.6 [-7.4; 0.1]) and MD = -4.6 [-8.2; -1.0], respectively). Intra- and interobserver reproducibility were very good for all imaging modalities (ICC = 0.86-0.98). CONCLUSION PETRA showed higher agreement in describing CF lung morphological changes than that of conventional sequences, whereas the Helbich-Bhalla scoring matched closely with that of CT. KEY POINTS • Spatial resolution of lung MRI is limited using non-ultra-short TE MRI technique • Ultra-short echo time (UTE) technique enables submillimeter 3D-MRI of airways • 3D-UTE MRI shows very good concordance with CT in assessing cystic fibrosis • Radiation-free 3D-UTE MRI enables the Helbich-Bhalla scoring without a need for contrast injection.
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Affiliation(s)
- Gaël Dournes
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France. .,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France. .,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France. .,Centre de Recherche Cardio-thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, 146 rue Léo Saignat, 33076, Bordeaux, Cedex, France.
| | - Fanny Menut
- CHU de Bordeaux, Service d'Imagerie de la Femme et de l'Enfant, Unité de Pneumologie pédiatrique, F-33000, Bordeaux, France
| | - Julie Macey
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France
| | - Michaël Fayon
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie de la Femme et de l'Enfant, Unité de Pneumologie pédiatrique, F-33000, Bordeaux, France
| | - Jean-François Chateil
- CHU de Bordeaux, Service d'Imagerie de la Femme et de l'Enfant, Unité de Pneumologie pédiatrique, F-33000, Bordeaux, France.,University of Bordeaux, Centre de Résonance Magnétique des Systèmes Biologiques, UMR 5536, 33076, Bordeaux, France
| | - Marjorie Salel
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France
| | - Olivier Corneloup
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France
| | - Michel Montaudon
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France
| | - Patrick Berger
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France
| | - François Laurent
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France
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Hochhegger B, de Souza VVS, Marchiori E, Irion KL, Souza AS, Elias Junior J, Rodrigues RS, Barreto MM, Escuissato DL, Mançano AD, Araujo Neto CA, Guimarães MD, Nin CS, Santos MK, Silva JLPE. Chest magnetic resonance imaging: a protocol suggestion. Radiol Bras 2016; 48:373-80. [PMID: 26811555 PMCID: PMC4725399 DOI: 10.1590/0100-3984.2014.0017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In the recent years, with the development of ultrafast sequences, magnetic
resonance imaging (MRI) has been established as a valuable diagnostic modality
in body imaging. Because of improvements in speed and image quality, MRI is now
ready for routine clinical use also in the study of pulmonary diseases. The main
advantage of MRI of the lungs is its unique combination of morphological and
functional assessment in a single imaging session. In this article, the authors
review most technical aspects and suggest a protocol for performing chest MRI.
The authors also describe the three major clinical indications for MRI of the
lungs: staging of lung tumors; evaluation of pulmonary vascular diseases; and
investigation of pulmonary abnormalities in patients who should not be exposed
to radiation.
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Affiliation(s)
- Bruno Hochhegger
- PhD, Associate Professor, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | | | - Edson Marchiori
- PhD, Full Professor Emeritus, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Klaus Loureiro Irion
- PhD, Consultant Radiologist, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
| | - Arthur Soares Souza
- PhD, Professor, Faculdade de Medicina de São José do Rio Preto (Famerp), São José do Rio Preto, SP, Brazil
| | - Jorge Elias Junior
- PhD, Associate Professor, Centro de Ciências das Imagens e Física Médica (CCIFM) - Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Rosana Souza Rodrigues
- PhD, Professor, Program of Post-graduation in Radiology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Miriam Menna Barreto
- PhD, Professor, Program of Post-graduation in Radiology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Dante Luiz Escuissato
- PhD, Associate Professor, Department of Medical Practice, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | | | | | - Marcos Duarte Guimarães
- PhD, Professor, Program of Post-graduation stricto sensu, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Carlos Schuler Nin
- MD, Resident in Radiology and Imaging Diagnosis, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Marcel Koenigkam Santos
- PhD, Attending Physician at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jorge Luiz Pereira E Silva
- PhD, Associate Professor, Department of Medicine and Diagnostic Support, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
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Sawicki LM, Grueneisen J, Buchbender C, Schaarschmidt BM, Gomez B, Ruhlmann V, Wetter A, Umutlu L, Antoch G, Heusch P. Comparative Performance of ¹⁸F-FDG PET/MRI and ¹⁸F-FDG PET/CT in Detection and Characterization of Pulmonary Lesions in 121 Oncologic Patients. J Nucl Med 2016; 57:582-6. [PMID: 26742715 DOI: 10.2967/jnumed.115.167486] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/16/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Our objective was to compare (18)F-FDG PET/MRI (performed using a contrast-enhanced T1-weighted fat-suppressed volume-interpolated breath-hold examination [VIBE]) with (18)F-FDG PET/CT for detecting and characterizing lung lesions in oncologic patients. METHODS In 121 oncologic patients with 241 lung lesions, PET/MRI was performed after PET/CT in a single-injection protocol (260 ± 58 MBq of (18)F-FDG). The detection rates were computed for MRI, the PET component of PET/CT, and the PET component of PET/MRI in relation to the CT component of PET/CT. Wilcoxon testing was used to assess differences in lesion contrast (4-point scale) and size between morphologic datasets and differences in image quality (4-point scale), SUVmean, SUVmax, and characterization (benign/malignant) between PET/MRI and PET/CT. Correlation was determined using the Pearson coefficient (r) for SUV and size and the Spearman rank coefficient (ρ) for contrast. RESULTS The detection rates for MRI, the PET component of PET/CT, and the PET component of PET/MRI were 66.8%, 42.7%, and 42.3%, respectively. There was a strong correlation in size (r= 0.98) and SUV (r= 0.91) and a moderate correlation in contrast (ρ = 0.48). Image quality was better for PET/CT than for PET/MRI (P< 0.001). Lesion measurements were smaller for MRI than for CT (P< 0.001). SUVmax and SUVmean were significantly higher for PET/MRI than for PET/CT (P< 0.001 each). There was no significant difference in lesion contrast (P= 0.11) or characterization (P= 0.076). CONCLUSION In the detection and characterization of lung lesions 10 mm or larger, (18)F-FDG PET/MRI and (18)F-FDG PET/CT perform comparably. Lesion size, SUV and characterization correlate strongly between the two modalities. However, the overall detection rate of PET/MRI remains inferior to that of PET/CT because of the limited ability of MRI to detect lesions smaller than 10 mm. Thus, thoracic staging with PET/MRI bears a risk of missing small lung metastases.
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Affiliation(s)
- Lino M Sawicki
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, Essen, Germany; and
| | - Johannes Grueneisen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, Essen, Germany; and
| | - Christian Buchbender
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Benedikt M Schaarschmidt
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Benedikt Gomez
- Department of Nuclear Medicine, University Duisburg-Essen, Essen, Germany
| | - Verena Ruhlmann
- Department of Nuclear Medicine, University Duisburg-Essen, Essen, Germany
| | - Axel Wetter
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, Essen, Germany; and
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, Essen, Germany; and
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Philipp Heusch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
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Sodhi KS, Khandelwal N, Saxena AK, Singh M, Agarwal R, Bhatia A, Lee EY. Rapid lung MRI in children with pulmonary infections: Time to change our diagnostic algorithms. J Magn Reson Imaging 2015; 43:1196-206. [DOI: 10.1002/jmri.25082] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/06/2015] [Indexed: 12/24/2022] Open
Affiliation(s)
- Kushaljit Singh Sodhi
- Department of Radio Diagnosis and Imaging; Post Graduate Institute of Medical Education and Research; Sector-12 Chandigarh India
| | - Niranjan Khandelwal
- Department of Radio Diagnosis and Imaging; Post Graduate Institute of Medical Education and Research; Sector-12 Chandigarh India
| | - Akshay Kumar Saxena
- Department of Radio Diagnosis and Imaging; Post Graduate Institute of Medical Education and Research; Sector-12 Chandigarh India
| | - Meenu Singh
- Department of Paediatrics; Post Graduate Institute of Medical Education and Research; Sector-12 Chandigarh India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine; Post Graduate Institute of Medical Education and Research; Sector-12 Chandigarh India
| | - Anmol Bhatia
- Department of Radio Diagnosis and Imaging; Post Graduate Institute of Medical Education and Research; Sector-12 Chandigarh India
| | - Edward Y. Lee
- Departments of Radiology and Medicine; Pulmonary Division, Boston Children's Hospital and Harvard Medical School; Boston Massachusetts USA
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Lee KH, Park CM, Lee SM, Lee JM, Cho JY, Paeng JC, Ahn SY, Goo JM. Pulmonary Nodule Detection in Patients with a Primary Malignancy Using Hybrid PET/MRI: Is There Value in Adding Contrast-Enhanced MR Imaging? PLoS One 2015; 10:e0129660. [PMID: 26065695 PMCID: PMC4465933 DOI: 10.1371/journal.pone.0129660] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/11/2015] [Indexed: 01/04/2023] Open
Abstract
Purpose To investigate the added value of post-contrast VIBE (volumetric-interpolated breath-hold examination) to PET/MR imaging for pulmonary nodule detection in patients with primary malignancies. Materials and Methods This retrospective institutional review board–approved study, with waiver of informed consent, included 51 consecutive patients who underwent 18F-fluorodeoxyglucose (FDG) PET/MR followed by PET/CT for cancer staging. In all patients, the thorax was examined with pre-and post-contrast VIBE MR with simultaneous PET acquisition. Two readers blinded to the patients’ data independently recorded their level of suspicion for pulmonary nodules based on PET, pre-contrast VIBE, and fused PET/MR images (first session), and reassessed them 4-weeks later after addition of post-contrast VIBE (second session). Jackknife alternative free-response receiver-operating-characteristic (JAFROC) analysis was performed, with PET/CT as the reference standard. Results A total of 151 pulmonary nodules (44 FDG-avid, 107 non-FDG-avid nodules) were detected on PET/CT, including 62 nodules≥5mm in diameter and 89 nodules<5mm. In the first session, the average nodule detection rate was 53.3% for all nodules, 97.7% for FDG-avid, 35.0% for non-FDG-avid nodules, 87.9% for nodules≥5mm and 29.2% for nodules<5mm. In the second session, the average detection rate was 53.3% for all nodules, 97.7% for FDG-avid, 35.0% for non-FDG-avid nodules, 85.5% for nodules≥5mm and 30.9% for nodules<5mm. The average JAFROC figure-of-merit was 0.837 in the first session and 0.848 in the second session. There were no significant differences in detection performance between sessions (P=0.48). Conclusion The addition of post-contrast VIBE to hybrid PET/MR imaging provided no additional value in the detection of pulmonary nodules.
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Affiliation(s)
- Kyung Hee Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, United States of America
- * E-mail:
| | - Sang Min Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jeong Yeon Cho
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Su Yeon Ahn
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
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Baez JC, Ciet P, Mulkern R, Seethamraju RT, Lee EY. Pediatric Chest MR Imaging. Magn Reson Imaging Clin N Am 2015; 23:337-49. [DOI: 10.1016/j.mric.2015.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Sommer G, Koenigkam-Santos M, Biederer J, Puderbach M. [Role of MRI for detection and characterization of pulmonary nodules]. Radiologe 2015; 54:470-7. [PMID: 24756231 DOI: 10.1007/s00117-013-2604-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Due to physical and technical limitations, magnetic resonance imaging (MRI) has hitherto played only a minor role in image-based diagnostics of the lungs. However, as a consequence of important methodological developments during recent years, MRI has developed into a technically mature and clinically well-proven method for specific pulmonary questions. OBJECTIVES AND METHODS The purpose of this article is to provide an overview on the currently available sequences and techniques for assessment of pulmonary nodules and analyzes the clinical significance according to the current literature. The main focus is on the detection of lung metastases, the detection of primary pulmonary malignancies in high-risk individuals and the differentiation between pulmonary nodules of benign and malignant character. RESULTS AND CONCLUSION The MRI technique has a sensitivity of approximately 80 % for detection of malignant pulmonary nodules compared to the reference standard low-dose computed tomography (CT) and is thus somewhat inferior to CT. Advantages of MRI on the other hand are a higher specificity in differentiating malignant and benign pulmonary nodules and the absence of ionizing radiation exposure. A systematic use of MRI as a primary tool for detection and characterization of pulmonary nodules is currently not recommended due to insufficient data. The diagnostic potential of MRI for early detection and staging of malignant pulmonary diseases, however, seems promising. Therefore, further evaluation of MRI as a secondary imaging modality in clinical trials is highly warranted.
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Affiliation(s)
- G Sommer
- Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz,
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Ciet P, Tiddens HAWM, Wielopolski PA, Wild JM, Lee EY, Morana G, Lequin MH. Magnetic resonance imaging in children: common problems and possible solutions for lung and airways imaging. Pediatr Radiol 2015; 45:1901-15. [PMID: 26342643 PMCID: PMC4666905 DOI: 10.1007/s00247-015-3420-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 04/20/2015] [Accepted: 06/17/2015] [Indexed: 11/11/2022]
Abstract
Pediatric chest MRI is challenging. High-resolution scans of the lungs and airways are compromised by long imaging times, low lung proton density and motion. Low signal is a problem of normal lung. Lung abnormalities commonly cause increased signal intenstities. Among the most important factors for a successful MRI is patient cooperation, so the long acquisition times make patient preparation crucial. Children usually have problems with long breath-holds and with the concept of quiet breathing. Young children are even more challenging because of higher cardiac and respiratory rates giving motion blurring. For these reasons, CT has often been preferred over MRI for chest pediatric imaging. Despite its drawbacks, MRI also has advantages over CT, which justifies its further development and clinical use. The most important advantage is the absence of ionizing radiation, which allows frequent scanning for short- and long-term follow-up studies of chronic diseases. Moreover, MRI allows assessment of functional aspects of the chest, such as lung perfusion and ventilation, or airways and diaphragm mechanics. In this review, we describe the most common MRI acquisition techniques on the verge of clinical translation, their problems and the possible solutions to make chest MRI feasible in children.
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Affiliation(s)
- Pierluigi Ciet
- Department of Radiology, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands ,Department of Pediatric Pulmonology and Allergology, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Harm A. W. M. Tiddens
- Department of Radiology, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands ,Department of Pediatric Pulmonology and Allergology, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Piotr A. Wielopolski
- Department of Radiology, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jim M. Wild
- Academic Radiology, University of Sheffield, Sheffield, UK
| | - Edward Y. Lee
- Departments of Radiology and Medicine, Pulmonary Divisions, Boston Children’s Hospital and Harvard Medical School, Boston, MA USA
| | - Giovanni Morana
- Department of Radiology, Ca’ Foncello Regional Hospital, Treviso, Italy
| | - Maarten H. Lequin
- Department of Radiology, Wilhelmina Children’s Hospital, University Medical Center, Wilhelmina Kinderziekenhuis (WKZ) Lundlaan 6, 3584 EA Utrecht, The Netherlands
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Kim HS, Lee KS, Ohno Y, van Beek EJ, Biederer J. PET/CT versus MRI for diagnosis, staging, and follow-up of lung cancer. J Magn Reson Imaging 2014; 42:247-60. [DOI: 10.1002/jmri.24776] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 09/27/2014] [Indexed: 12/19/2022] Open
Affiliation(s)
- Hyun Su Kim
- Department of Radiology and Center for Imaging Science; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Kyung Soo Lee
- Department of Radiology and Center for Imaging Science; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Yoshiharu Ohno
- Division of Functional and Diagnostic Imaging Research; Department of Radiology; and Advanced Biomedical Imaging Research Centre, Kobe University Graduate School of Medicine; Kobe Japan
| | | | - Juergen Biederer
- Radiologie Darmstadt; Gross-Gerau County Hospital; Gross-Gerau Germany
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Yan C, Tan X, Wei Q, Feng R, Li C, Wu Y, Hao P, Chan Q, Xiong W, Xu J, Xu Y. Lung MRI of invasive fungal infection at 3 Tesla: evaluation of five different pulse sequences and comparison with multidetector computed tomography (MDCT). Eur Radiol 2014; 25:550-7. [PMID: 25231132 DOI: 10.1007/s00330-014-3432-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 08/20/2014] [Accepted: 09/03/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the diagnostic performance of five MR sequences to detect pulmonary infectious lesions in patients with invasive fungal infection (IFI), using multidetector computed tomography (MDCT) as the reference standard. METHODS Thirty-four immunocompromised patients with suspected IFI underwent MDCT and MRI. The MR studies were performed using five pulse sequences at 3.0 T: T2-weighted turbo spin echo (TSE), short-tau inversion recovery (STIR), spectrally selective attenuated inversion recovery (SPAIR), T1-weighted high resolution isotropic volume excitation (e-THRIVE) and T1-weighted fast field echo (T1-FFE). The size, lesion-to-lung contrast ratio and the detectability of pulmonary lesions on MR images were assessed. Image quality and artefacts on different sequences were also rated. RESULTS A total of 84 lesions including nodules (n = 44) and consolidation (n = 40) were present in 75 lobes. SPAIR and e-THRIVE images achieved high overall lesion-related sensitivities for the detection of pulmonary abnormalities (90.5% and 86.9%, respectively). STIR showed the highest lesion-to-lung contrast ratio for nodules (21.8) and consolidation (17.0), whereas TSE had the fewest physiological artefacts. CONCLUSIONS MRI at 3.0 T can depict clinically significant pulmonary IFI abnormalities with high accuracy compared to MDCT. SPAIR and e-THRIVE are preferred sequences for the detection of infectious lesions of 5 mm and larger. KEY POINTS • A radiation-free radiological method is desirable for assessing pulmonary infectious lesions • MRI at 3 T can depict lung infiltrates with good concordance to MDCT • SPAIR and e-THRIVE are favourable sequences for the detection of pulmonary lesions • The greatest benefit is for the diagnosis of lesions larger than 5 mm.
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Affiliation(s)
- Chenggong Yan
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, People's Republic of China
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Investigating the feasibility of rapid MRI for image-guided motion management in lung cancer radiotherapy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:485067. [PMID: 24524077 PMCID: PMC3913339 DOI: 10.1155/2014/485067] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 11/06/2013] [Accepted: 11/07/2013] [Indexed: 12/25/2022]
Abstract
Cycle-to-cycle variations in respiratory motion can cause significant geometric and dosimetric errors in the administration of lung cancer radiation therapy. A common limitation of the current strategies for motion management is that they assume a constant, reproducible respiratory cycle. In this work, we investigate the feasibility of using rapid MRI for providing long-term imaging of the thorax in order to better capture cycle-to-cycle variations. Two nonsmall-cell lung cancer patients were imaged (free-breathing, no extrinsic contrast, and 1.5 T scanner). A balanced steady-state-free-precession (b-SSFP) sequence was used to acquire cine-2D and cine-3D (4D) images. In the case of Patient 1 (right midlobe lesion, ~40 mm diameter), tumor motion was well correlated with diaphragmatic motion. In the case of Patient 2, (left upper-lobe lesion, ~60 mm diameter), tumor motion was poorly correlated with diaphragmatic motion. Furthermore, the motion of the tumor centroid was poorly correlated with the motion of individual points on the tumor boundary, indicating significant rotation and/or deformation. These studies indicate that image quality and acquisition speed of cine-2D MRI were adequate for motion monitoring. However, significant improvements are required to achieve comparable speeds for truly 4D MRI. Despite several challenges, rapid MRI offers a feasible and attractive tool for noninvasive, long-term motion monitoring.
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3 Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: initial results in comparison to HRCT. Eur J Radiol 2013; 83:e61-6. [PMID: 24189389 DOI: 10.1016/j.ejrad.2013.09.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/20/2013] [Accepted: 09/03/2013] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the diagnostic accuracy of 3 Tesla proton MRI for the assessment of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia. MATERIAL AND METHODS In a prospective study, 3 Tesla MRI was performed in 19 febrile neutropenic patients (5 women, 14 men; mean age 61 years ± 14.2; range 23-77 years). All patients underwent high-resolution CT less than 24h prior to MRI. The MRI protocol (Magnetom Tim Trio, Siemens) included a T2-weighted HASTE sequence (TE/TR: 49 ms/∞, slice thickness 6mm) and a high-resolution 3D VIBE sequence with an ultra-short TE<1 ms (TE/TR 0.8/2.9 ms, slice thickness 2mm). The VIBE sequence was examined before and after intravenous injection of 0.1 mmol/kg gadoterate meglumine (Dotarem, Guerbet). The presence of pulmonary abnormalities, their location within the lung, and lesion type (nodules, consolidations, glass opacity areas) were analyzed by one reader and compared to the findings of HRCT, which was evaluated by a second independent radiologist who served as the reference standard. The findings were compared per lobe in each patient and rated as true positive (TP) findings if all three characteristics (presence, location, and lesion type) listed above were concordant to HRCT. RESULTS Pulmonary abnormalities were characterized by 3 Tesla MRI with a sensitivity of 82.3% and a specificity of 78.6%, resulting in an overall accuracy of 88% (NPV/PPV 66.7%/89.5%). In 51 lobes (19 of 19 patients), pulmonary abnormalities visualized by MR were judged to be concordant in their location and in the lesion type identified by both readers. In 22 lobes (11 of 19 patients), no abnormalities were present on either MR or HRCT (true negative). In 6 lobes (5 of 19 patients), ground glass opacity areas were detected on MRI but were not visible on HRCT (false positives). In 11 lobes (7 of 19 patients), MRI failed to detect ground glass opacity areas identified by HRCT. However, since the abnormalities were disseminated in these patients, accurate treatment decisions were possible in every case based on MRI. In one case MRI showed a central area of cavitation, which was not visualized by HRCT. CONCLUSION Infectious nodules and consolidations can be detected in neutropenic patients with acute myeloid leukemia with a sufficient diagnostic accuracy by 3 Tesla MRI. Detection of ground glass opacity areas is the main limitation of 3-Tesla MRI when compared to HRCT.
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Chest MR imaging in the follow-up of pulmonary alterations in paediatric patients with middle lobe syndrome: comparison with chest X-ray. Radiol Med 2012; 118:444-55. [PMID: 23090250 DOI: 10.1007/s11547-012-0889-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 12/22/2011] [Indexed: 10/27/2022]
Abstract
PURPOSE The authors evaluated the role of magnetic resonance (MR) imaging of the chest in comparison with chest X-ray in the follow-up of pulmonary abnormalities detected by computed tomography (CT) in paediatric patients with middle lobe syndrome. MATERIALS AND METHODS Seventeen patients with middle lobe syndrome (mean age 6.2 years) underwent chest CT at the time of diagnosis (100 kV, CARE dose with quality reference of 70 mAs; collimation 24×1.2 mm; rotation time 0.33 s; scan time 5 s); at follow-up after a mean of 15.3 months, all patients were evaluated with chest MR imaging with a respiratory-triggered T2-weighted BLADE sequence (TR 2,000; TE 27 ms; FOV 400 mm; flip angle 150°; slice thickness 5 mm) and chest X-ray. Images from each modality were assessed for the presence of pulmonary consolidations, bronchiectases, bronchial wall thickening and mucous plugging. Hilar and mediastinal lymphadenopathies were assessed on CT and MR images. RESULTS Baseline CT detected consolidations in 100% of patients, bronchiectases in 35%, bronchial wall thickening in 53% and mucous plugging in 35%. MR imaging and chest X-ray identified consolidations in 65% and 35%, bronchiectases in 35% and 29%, bronchial wall thickening in 59% and 6% and mucous plugging in 25% and 0%, respectively. Lymphadenopathy was seen in 64% of patients at CT and in 47% at MR imaging. CONCLUSIONS Patients with middle lobe syndrome show a wide range of parenchymal and bronchial abnormalities at diagnosis. Compared with MR imaging, chest X-ray seems to underestimate these changes. Chest MR imaging might represent a feasible and radiation-free option for an overall assessment of the lung in the follow-up of patients with middle lobe syndrome.
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Bauman G, Eichinger M. Ventilation and perfusion magnetic resonance imaging of the lung. Pol J Radiol 2012; 77:37-46. [PMID: 22802864 PMCID: PMC3389953 DOI: 10.12659/pjr.882579] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 01/19/2012] [Indexed: 02/02/2023] Open
Abstract
A close interaction between the respiratory pump, pulmonary parenchyma and blood circulation is essential for a normal lung function. Many pulmonary diseases present, especially in their initial phase, a variable regional impairment of ventilation and perfusion. In the last decades various techniques have been established to measure the lung function. Besides the global pulmonary function tests (PFTs) imaging techniques gained increasing importance to detect local variations in lung function, especially for ventilation and perfusion assessment. Imaging modalities allow for a deeper regional insight into pathophysiological processes and enable improved planning of invasive procedures. In contrast to computed tomography (CT) and the nuclear medicine techniques, magnetic resonance imaging (MRI), as a radiation free imaging modality gained increasing importance since the early 1990 for the assessment of pulmonary function. The major inherent problems of lung tissue, namely the low proton density and the pulmonary and cardiac motion, were overcome in the last years by a constant progress in MR technology. Some MR techniques are still under development, a process which is driven by scientific questions regarding the physiology and pathophysiology of pulmonary diseases, as well as by the need for fast and robust clinically applicable imaging techniques as safe therapy monitoring tools. MRI can be considered a promising ionizing-free alternative to techniques like CT or nuclear medicine techniques for the evaluation of lung function. The goal of this article is to provide an overview on selected MRI techniques for the assessment of pulmonary ventilation and perfusion.
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Affiliation(s)
- Grzegorz Bauman
- German Cancer Research Center, Department of Medical Physics in Radiology, Heidelberg, Germany
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Biederer J, Beer M, Hirsch W, Wild J, Fabel M, Puderbach M, Van Beek EJR. MRI of the lung (2/3). Why … when … how? Insights Imaging 2012; 3:355-71. [PMID: 22695944 PMCID: PMC3481084 DOI: 10.1007/s13244-011-0146-8] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 11/20/2011] [Accepted: 12/19/2011] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Among the modalities for lung imaging, proton magnetic resonance imaging (MRI) has been the latest to be introduced into clinical practice. Its value to replace X-ray and computed tomography (CT) when radiation exposure or iodinated contrast material is contra-indicated is well acknowledged: i.e. for paediatric patients and pregnant women or for scientific use. One of the reasons why MRI of the lung is still rarely used, except in a few centres, is the lack of consistent protocols customised to clinical needs. METHODS This article makes non-vendor-specific protocol suggestions for general use with state-of-the-art MRI scanners, based on the available literature and a consensus discussion within a panel of experts experienced in lung MRI. RESULTS Various sequences have been successfully tested within scientific or clinical environments. MRI of the lung with appropriate combinations of these sequences comprises morphological and functional imaging aspects in a single examination. It serves in difficult clinical problems encountered in daily routine, such as assessment of the mediastinum and chest wall, and even might challenge molecular imaging techniques in the near future. CONCLUSION This article helps new users to implement appropriate protocols on their own MRI platforms. Main Messages • MRI of the lung can be readily performed on state-of-the-art 1.5-T MRI scanners. • Protocol suggestions based on the available literature facilitate its use for routine • MRI offers solutions for complicated thoracic masses with atelectasis and chest wall invasion. • MRI is an option for paediatrics and science when CT is contra-indicated.
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Affiliation(s)
- J Biederer
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Diagnostic Radiology, Arnold-Heller-Straße 3, Haus 23, 24105, Kiel, Germany,
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Morelli JN, Runge VM, Ai F, Attenberger U, Vu L, Schmeets SH, Nitz WR, Kirsch JE. An image-based approach to understanding the physics of MR artifacts. Radiographics 2011; 31:849-66. [PMID: 21571661 DOI: 10.1148/rg.313105115] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
As clinical magnetic resonance (MR) imaging becomes more versatile and more complex, it is increasingly difficult to develop and maintain a thorough understanding of the physical principles that govern the changing technology. This is particularly true for practicing radiologists, whose primary obligation is to interpret clinical images and not necessarily to understand complex equations describing the underlying physics. Nevertheless, the physics of MR imaging plays an important role in clinical practice because it determines image quality, and suboptimal image quality may hinder accurate diagnosis. This article provides an image-based explanation of the physics underlying common MR imaging artifacts, offering simple solutions for remedying each type of artifact. Solutions that have emerged from recent technologic advances with which radiologists may not yet be familiar are described in detail. Types of artifacts discussed include those resulting from voluntary and involuntary patient motion, magnetic susceptibility, magnetic field inhomogeneities, gradient nonlinearity, standing waves, aliasing, chemical shift, and signal truncation. With an improved awareness and understanding of these artifacts, radiologists will be better able to modify MR imaging protocols so as to optimize clinical image quality, allowing greater confidence in diagnosis.
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Affiliation(s)
- John N Morelli
- Department of Radiology, Scott and White Memorial Hospital and Clinic, Texas A&M Health Sciences Center, 2401 S 31st St, Temple, TX 76508, USA.
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Sieren JC, Ohno Y, Koyama H, Sugimura K, McLennan G. Recent technological and application developments in computed tomography and magnetic resonance imaging for improved pulmonary nodule detection and lung cancer staging. J Magn Reson Imaging 2011; 32:1353-69. [PMID: 21105140 DOI: 10.1002/jmri.22383] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This review compares the emerging technologies and approaches in the application of magnetic resonance (MR) and computed tomography (CT) imaging for the assessment of pulmonary nodules and staging of malignant findings. Included in this review is a brief definition of pulmonary nodules and an introduction to the challenges faced. We have highlighted the current status of both MR and CT for the early detection of lung nodules. Developments are detailed in this review for the management of pulmonary nodules using advanced imaging, including: dynamic imaging studies, dual energy CT, computer aided detection and diagnosis, and imaging assisted nodule biopsy approaches which have improved lung nodule detection and diagnosis rates. Recent advancements linking in vivo imaging to corresponding histological pathology are also highlighted. In vivo imaging plays a pivotal role in the clinical staging of pulmonary nodules through TNM assessment. While CT and positron emission tomography (PET)/CT are currently the most commonly clinically employed modalities for pulmonary nodule staging, studies are presented that highlight the augmentative potential of MR.
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Affiliation(s)
- Jessica C Sieren
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA.
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3T MRI in evaluation of asbestos-related thoracic diseases - preliminary results. Radiol Oncol 2010; 44:92-6. [PMID: 22933897 PMCID: PMC3423685 DOI: 10.2478/v10019-010-0027-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 02/11/2010] [Indexed: 11/26/2022] Open
Abstract
Background 3T high-field magnetic resonance imaging (MRI) scanners have recently become available for the clinical use and are being increasingly applied in the field of whole-body imaging and chest imaging as well. The aim of this study was to evaluate the diagnostic potential of 3 T MRI as a complementary imaging modality to CT in detecting the pathological changes of asbestos-related thoracic diseases. Patients and methods Fifteen patients with the asbestos-related thoracic disease were scheduled for 3T MRI. Five had a benign form of the disease and 10 had malignant pleural mesothelioma (MPM). From the patients with a benign form of the disease their last CT examination in digital form was acquired and patients with MPM were scheduled for CT examination with contrast media. The protocol of MR imaging consists of T2-weighted cardiac-gated breath-hold turbo spin echo (TSE) sequences in coronal, sagittal and axial plane and T1-weighted cardiac-gated breath-hold TSE black blood in axial plane. In T2-weighted sequences in axial plane, fat saturation was also used. CT examinations were obtained with the administration of the contrast medium from lung apices to the lower end of the liver. Images of 5 mm (mediastinum window) and 3 mm (lung window) in axial plan were reconstructed. MRI signal intensity of lesions and adjacent muscles on Syngo MultiModality Work Place were measured. Results Compared to muscles pleural plaques appeared hypo-intense to iso-intense on T1 weighted images (in 100%) and also hypo-intense on T2 fs-weighted images (in 100%). MPM appeared inhomogeneous hypo-intense to iso-intense on T1-weighted and hyperintense on T2 fs-weighted images in all patients (100%). Conclusions These preliminary results pointed out that MRI was equal or even better compared with CT examination for detecting possible malignant potential of pleural changes in the asbestos-related pleural disease, using signal intensity measurements of T2 fs-weighted images. The 3T MRI enabled the accurate determination of chest pathology and it could be used for imaging of patients with the asbestos-related thoracic disease. MRI is particularly valuable because a patient is not exposed to the harmful radiation which is important if imaging methods are used repeatedly, like in screening programs or in monitoring of treatment results. This finding turned us to propose 3T MRI imaging technique as a non-ionizing imaging method for the follow-up of patients with the isolated pleural form of the asbestos-related disease.
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Hellinger JC, Medina LS, Epelman M. Pediatric Advanced Imaging and Informatics: State of the Art. Semin Ultrasound CT MR 2010; 31:171-93. [DOI: 10.1053/j.sult.2010.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ley-Zaporozhan J, Ley S, Eberhardt R, Kauczor HU, Heussel CP. Visualization of morphological parenchymal changes in emphysema: Comparison of different MRI sequences to 3D-HRCT. Eur J Radiol 2010; 73:43-9. [DOI: 10.1016/j.ejrad.2008.09.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Revised: 08/31/2008] [Accepted: 09/24/2008] [Indexed: 11/25/2022]
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Henzler T, Dietrich O, Krissak R, Wichmann T, Lanz T, Reiser MF, Schoenberg SO, Fink C. Half-Fourier-acquisition single-shot turbo spin-echo (HASTE) MRI of the lung at 3 Tesla using parallel imaging with 32-receiver channel technology. J Magn Reson Imaging 2009; 30:541-6. [PMID: 19711408 DOI: 10.1002/jmri.21882] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To assess the feasibility of half-Fourier-acquisition single-shot turbo spin-echo (HASTE) of the lung at 3 Tesla (T) using parallel imaging with a prototype of a 32-channel torso array coil, and to determine the optimum acceleration factor for the delineation of intrapulmonary anatomy. MATERIALS AND METHODS Nine volunteers were examined on a 32-channel 3T MRI system using a prototype 32-channel-torso-array-coil. HASTE-MRI of the lung was acquired at both, end-inspiratory and end-expiratory breathhold with parallel imaging (Generalized autocalibrating partially parallel acquisitions = GRAPPA) using acceleration factors ranging between R = 1 (TE = 42 ms) and R = 6 (TE = 16 ms). The image quality of intrapulmonary anatomy and subjectively perceived noise level was analyzed by two radiologists in consensus. In addition quantitative measurements of the signal-to-noise ratio (SNR) of HASTE with different acceleration factors were assessed in phantom measurements. RESULTS Using an acceleration factor of R = 4 image blurring was substantially reduced compared with lower acceleration factors resulting in sharp delineation of intrapulmonary structures in expiratory scans. For inspiratory scans an acceleration factor of 2 provided the best image quality. Expiratory scans had a higher subjectively perceived SNR than inspiratory scans. CONCLUSION Using optimized multi-element coil geometry HASTE-MRI of the lung is feasible at 3T with acceleration factors up to 4. Compared with nonaccelerated acquisitions, shorter echo times and reduced image blurring are achieved. Expiratory scanning may be favorable to compensate for susceptibility associated signal loss at 3T.
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Affiliation(s)
- Thomas Henzler
- Department of Clinical Radiology and Nuclear Medicine, University of Heidelberg, Germany.
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Assessment of Chest High-Field Magnetic Resonance Imaging in Children and Young Adults With Noncystic Fibrosis Chronic Lung Disease. Invest Radiol 2009; 44:532-8. [DOI: 10.1097/rli.0b013e3181b4c1ba] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schmidt GP, Baur-Melnyk A, Haug A, Utzschneider S, Becker CR, Tiling R, Reiser MF, Hermann KA. Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer. Eur Radiol 2009; 19:1366-78. [PMID: 19190917 DOI: 10.1007/s00330-008-1289-y] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Accepted: 12/09/2008] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to assess the diagnostic accuracy of whole-body MRI (WB-MRI) at 1.5 T or 3 T compared with FDG-PET-CT in the follow-up of patients suffering from colorectal cancer. In a retrospective study, 24 patients with a history of colorectal cancer and suspected tumour recurrence underwent FDG-PET-CT and WB-MRI with the use of parallel imaging (PAT) for follow-up. High resolution coronal T1w-TSE and STIR sequences at four body levels, HASTE imaging of the lungs, contrast-enhanced T1w- and T2w-TSE sequences of the liver, brain, abdomen and pelvis were performed, using WB-MRI at either 1.5 T (n = 14) or 3 T (n = 10). Presence of local recurrent tumour, lymph node involvement and distant metastatic disease was confirmed using radiological follow-up within at least 5 months as a standard of reference. Seventy seven malignant foci in 17 of 24 patients (71%) were detected with both WB-MRI and PET-CT. Both investigations concordantly revealed two local recurrent tumours. PET-CT detected significantly more lymph node metastases (sensitivity 93%, n = 27/29) than WB-MRI (sensitivity 63%, n = 18/29). PET-CT and WB-MRI achieved a similar sensitivity for the detection of organ metastases with 80% and 78%, respectively (37/46 and 36/46). WB-MRI detected brain metastases in one patient. One false-positive local tumour recurrence was indicated by PET-CT. Overall diagnostic accuracy for PET-CT was 91% (sensitivity 86%, specificity 96%) and 83% for WB-MRI (sensitivity 72%, specificity 93%), respectively. Examination time for WB-MRI at 1.5 T and 3 T was 52 min and 43 min, respectively; examination time for PET-CT was 103 min. Initial results suggest that differences in accuracy for local and distant metastases detection using FDG-PET-CT and WB-MRI for integrated screening of tumour recurrence in colorectal cancer depend on the location of the malignant focus. Our results show that nodal disease is better detected using PET-CT, whereas organ disease is depicted equally well by both investigations.
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Affiliation(s)
- G P Schmidt
- Department of Clinical Radiology, University Hospitals Grosshadern, Ludwig Maximilian University Munich, Marchioninistr. 15, 81377, Munich, Germany.
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VAN BEEK EJR, TCHATALBACHEV V, WILD JM. Lung magnetic resonance imaging – an update. IMAGING 2008. [DOI: 10.1259/imaging/63202218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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