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Ozawa Y, Nagata H, Ueda T, Oshima Y, Hamabuchi N, Yoshikawa T, Takenaka D, Ohno Y. Chest Magnetic Resonance Imaging: Advances and Clinical Care. Clin Chest Med 2024; 45:505-529. [PMID: 38816103 DOI: 10.1016/j.ccm.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Many promising study results as well as technical advances for chest magnetic resonance imaging (MRI) have demonstrated its academic and clinical potentials during the last few decades, although chest MRI has been used for relatively few clinical situations in routine clinical practice. However, the Fleischner Society as well as the Japanese Society of Magnetic Resonance in Medicine have published a few white papers to promote chest MRI in routine clinical practice. In this review, we present clinical evidence of the efficacy of chest MRI for 1) thoracic oncology and 2) pulmonary vascular diseases.
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Affiliation(s)
- Yoshiyuki Ozawa
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroyuki Nagata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takahiro Ueda
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takeshi Yoshikawa
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Daisuke Takenaka
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Yoshiharu Ohno
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
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Cavion CC, Altmayer S, Forte GC, Feijó Andrade RG, Hochhegger DQDR, Zaguini Francisco M, Camargo C, Patel P, Hochhegger B. Diagnostic Performance of MRI for the Detection of Pulmonary Nodules: A Systematic Review and Meta-Analysis. Radiol Cardiothorac Imaging 2024; 6:e230241. [PMID: 38634743 PMCID: PMC11056753 DOI: 10.1148/ryct.230241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 02/18/2024] [Accepted: 03/07/2024] [Indexed: 04/19/2024]
Abstract
Purpose To perform a meta-analysis of the diagnostic performance of MRI for the detection of pulmonary nodules, with use of CT as the reference standard. Materials and Methods PubMed, Embase, Scopus, and other databases were systematically searched for studies published from January 2000 to March 2023 evaluating the performance of MRI for diagnosis of lung nodules measuring 4 mm or larger, with CT as reference. Studies including micronodules, nodules without size stratification, or those from which data for contingency tables could not be extracted were excluded. Primary outcomes were the per-lesion sensitivity of MRI and the rate of false-positive nodules per patient (FPP). Subgroup analysis by size and meta-regression with other covariates were performed. The study protocol was registered in the International Prospective Register of Systematic Reviews, or PROSPERO (no. CRD42023437509). Results Ten studies met inclusion criteria (1354 patients and 2062 CT-detected nodules). Overall, per-lesion sensitivity of MRI for nodules measuring 4 mm or larger was 87.7% (95% CI: 81.1, 92.2), while the FPP rate was 12.4% (95% CI: 7.0, 21.1). Subgroup analyses demonstrated that MRI sensitivity was 98.5% (95% CI: 90.4, 99.8) for nodules measuring at least 8-10 mm and 80.5% (95% CI: 71.5, 87.1) for nodules less than 8 mm. Conclusion MRI demonstrated a good overall performance for detection of pulmonary nodules measuring 4 mm or larger and almost equal performance to CT for nodules measuring at least 8-10 mm, with a low rate of FPP. Systematic review registry no. CRD42023437509 Keywords: Lung Nodule, Lung Cancer, Lung Cancer Screening, MRI, CT Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- César Campagnolo Cavion
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Stephan Altmayer
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Gabriele Carra Forte
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Rubens Gabriel Feijó Andrade
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Daniela Quinto dos Reis Hochhegger
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Martina Zaguini Francisco
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Capitulino Camargo
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Pratik Patel
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
| | - Bruno Hochhegger
- From the Department of Radiology, Pontifícia Universidade
Católica do Rio Grande do Sul, Av Ipiranga, 6681 – Partenon, Porto
Alegre, Rio Grande do Sul, Brazil, 90619-900 (C.C.C., G.C.F., R.G.F.A.);
Department of Radiology, Stanford University, Stanford, Calif (S.A.); Department
of Radiology, College of Medicine, University of Florida, Gainesville, Fla
(D.Q.d.R.H., P.P., B.H.); and Universidade Federal de Ciências da
Saúde de Porto Alegre, Porto Alegre, Brazil (M.Z.F., C.C.J.)
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Ohno Y, Ozawa Y, Nagata H, Ueda T, Yoshikawa T, Takenaka D, Koyama H. Lung Magnetic Resonance Imaging: Technical Advancements and Clinical Applications. Invest Radiol 2024; 59:38-52. [PMID: 37707840 DOI: 10.1097/rli.0000000000001017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
ABSTRACT Since lung magnetic resonance imaging (MRI) became clinically available, limited clinical utility has been suggested for applying MRI to lung diseases. Moreover, clinical applications of MRI for patients with lung diseases or thoracic oncology may vary from country to country due to clinical indications, type of health insurance, or number of MR units available. Because of this situation, members of the Fleischner Society and of the Japanese Society for Magnetic Resonance in Medicine have published new reports to provide appropriate clinical indications for lung MRI. This review article presents a brief history of lung MRI in terms of its technical aspects and major clinical indications, such as (1) what is currently available, (2) what is promising but requires further validation or evaluation, and (3) which developments warrant research-based evaluations in preclinical or patient studies. We hope this article will provide Investigative Radiology readers with further knowledge of the current status of lung MRI and will assist them with the application of appropriate protocols in routine clinical practice.
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Affiliation(s)
- Yoshiharu Ohno
- From the Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y. Ohno); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y. Ohno and H.N.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y. Ozawa and T.U.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (T.Y., D.T.); and Department of Radiology, Advanced Diagnostic Medical Imaging, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (H.K.)
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Bak SH, Kim C, Kim CH, Ohno Y, Lee HY. Magnetic resonance imaging for lung cancer: a state-of-the-art review. PRECISION AND FUTURE MEDICINE 2022. [DOI: 10.23838/pfm.2021.00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Feng H, Shi G, Liu H, Du Y, Zhang N, Wang Y. The Value of PETRA in Pulmonary Nodules of <3 cm Among Patients With Lung Cancer. Front Oncol 2021; 11:649625. [PMID: 34084745 PMCID: PMC8167054 DOI: 10.3389/fonc.2021.649625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to evaluate the visibility of different subgroups of lung nodules of <3 cm using the pointwise encoding time reduction with radial acquisition (PETRA) sequence on 3T magnetic resonance imaging (MRI) in comparison with that obtained using low-dose computed tomography (LDCT). Methods The appropriate detection rate was calculated for each of the different subgroups of lung nodules of <3 cm. The mean diameter of each detected nodule was determined. The detection rates and diameters of the lung nodules detected by MRI with the PETRA sequence were compared with those detected by computed tomography (CT). The sensitivity of detection for the different subgroups of pulmonary nodules was determined based on the location, size, type of nodules and morphologic characteristics. Agreement of nodule characteristics between CT and MRI were assessed by intraclass correlation coefficient (ICC) and Kappa test. Results The CT scans detected 256 lung nodules, comprising 99 solid nodules (SNs) and 157 subsolid nodules with a mean nodule diameter of 8.3 mm. For the SNs, the MRI detected 30/47 nodules of <6 mm in diameter and 52/52 nodules of ≥6 mm in diameter. For the subsolid nodules, the MRI detected 30/51 nodules of <6 mm in diameter and 102/106 nodules of ≥6 mm in diameter. The PETRA sequence returned a high detection rate (84%). The detection rates of SN, ground glass nodules, and PSN were 82%, 72%, and 94%, respectively. For nodules with a diameter of >6 mm, the sensitivity of the PETRA sequence reached 97%, with a higher rate for nodules located in the upper lung fields than those in the middle and lower lung fields. Strong agreement was found between the CT and PETRA results (correlation coefficients = 0.97). Conclusion The PETRA technique had high sensitivity for different type of nodule detection and enabled accurate assessment of their diameter and morphologic characteristics. It may be an effective alternative to CT as a tool for screening and follow up pulmonary nodules.
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Affiliation(s)
- Hui Feng
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Gaofeng Shi
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hui Liu
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yu Du
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ning Zhang
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yaning Wang
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Tanaka Y, Ohno Y, Hanamatsu S, Obama Y, Ueda T, Ikeda H, Iwase A, Fukuba T, Hattori H, Murayama K, Yoshikawa T, Takenaka D, Koyama H, Toyama H. State-of-the-art MR Imaging for Thoracic Diseases. Magn Reson Med Sci 2021; 21:212-234. [PMID: 33952785 PMCID: PMC9199970 DOI: 10.2463/mrms.rev.2020-0184] [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] [Indexed: 11/09/2022] Open
Abstract
Since thoracic MR imaging was first used in a clinical setting, it has been suggested that MR imaging has limited clinical utility for thoracic diseases, especially lung diseases, in comparison with x-ray CT and positron emission tomography (PET)/CT. However, in many countries and states and for specific indications, MR imaging has recently become practicable. In addition, recently developed pulmonary MR imaging with ultra-short TE (UTE) and zero TE (ZTE) has enhanced the utility of MR imaging for thoracic diseases in routine clinical practice. Furthermore, MR imaging has been introduced as being capable of assessing pulmonary function. It should be borne in mind, however, that these applications have so far been academically and clinically used only for healthy volunteers, but not for patients with various pulmonary diseases in Japan or other countries. In 2020, the Fleischner Society published a new report, which provides consensus expert opinions regarding appropriate clinical indications of pulmonary MR imaging for not only oncologic but also pulmonary diseases. This review article presents a brief history of MR imaging for thoracic diseases regarding its technical aspects and major clinical indications in Japan 1) in terms of what is currently available, 2) promising but requiring further validation or evaluation, and 3) developments warranting research investigations in preclinical or patient studies. State-of-the-art MR imaging can non-invasively visualize lung structural and functional abnormalities without ionizing radiation and thus provide an alternative to CT. MR imaging is considered as a tool for providing unique information. Moreover, prospective, randomized, and multi-center trials should be conducted to directly compare MR imaging with conventional methods to determine whether the former has equal or superior clinical relevance. The results of these trials together with continued improvements are expected to update or modify recommendations for the use of MRI in near future.
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Affiliation(s)
- Yumi Tanaka
- Department of Radiology, Fujita Health University School of Medicine
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine.,Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine
| | - Satomu Hanamatsu
- Department of Radiology, Fujita Health University School of Medicine
| | - Yuki Obama
- Department of Radiology, Fujita Health University School of Medicine
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine
| | - Akiyoshi Iwase
- Department of Radiology, Fujita Health University Hospital
| | - Takashi Fukuba
- Department of Radiology, Fujita Health University Hospital
| | - Hidekazu Hattori
- Department of Radiology, Fujita Health University School of Medicine
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine
| | | | | | | | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine
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Huang YS, Niisato E, Su MYM, Benkert T, Hsu HH, Shih JY, Chen JS, Chang YC. Detecting small pulmonary nodules with spiral ultrashort echo time sequences in 1.5 T MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:399-409. [PMID: 32902778 DOI: 10.1007/s10334-020-00885-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study investigated ultrashort echo time (UTE) sequences in 1.5 T magnetic resonance imaging (MRI) for small lung nodule detection. MATERIALS AND METHODS A total of 120 patients with 165 small lung nodules before video-associated thoracoscopic resection were enrolled. MRI sequences included conventional volumetric interpolated breath-hold examination (VIBE, scan time 16 s), spiral UTE (TE 0.05 ms) with free-breathing (scan time 3.5-5 min), and breath-hold sequences (scan time 20 s). Chest CT provided a standard reference for nodule size and morphology. Nodule detection sensitivity was evaluated on a lobe-by-lobe basis. RESULTS The nodule detection rate was significantly higher in spiral UTE free-breathing (> 78%, p < 0.05) and breath-hold sequences (> 75%, p < 0.05) compared with conventional VIBE (> 55%), reaching 100% when nodule size was > 16 mm, and reaching 95% when nodules were in solid morphology, regardless of size. The inter-sequence reliability between free-breathing and breath-hold spiral UTE was good (κ > 0.80). Inter-reader agreement was also high (κ > 0.77) for spiral UTE sequences. Nodule size measurements were consistent between CT and spiral UTE MRI, with a minimal bias up to 0.2 mm. DISCUSSION Spiral UTE sequences detect small lung nodules that warrant surgery, offers realistic scan times for clinical work, and could be implemented as part of routine lung MRI.
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Affiliation(s)
- Yu-Sen Huang
- Department of Medical Imaging, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 100, Taiwan
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Mao-Yuan Marine Su
- Department of Medical Imaging, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 100, Taiwan
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 100, Taiwan.
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan.
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Hatabu H, Ohno Y, Gefter WB, Parraga G, Madore B, Lee KS, Altes TA, Lynch DA, Mayo JR, Seo JB, Wild JM, van Beek EJR, Schiebler ML, Kauczor HU. Expanding Applications of Pulmonary MRI in the Clinical Evaluation of Lung Disorders: Fleischner Society Position Paper. Radiology 2020; 297:286-301. [PMID: 32870136 DOI: 10.1148/radiol.2020201138] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Pulmonary MRI provides structural and quantitative functional images of the lungs without ionizing radiation, but it has had limited clinical use due to low signal intensity from the lung parenchyma. The lack of radiation makes pulmonary MRI an ideal modality for pediatric examinations, pregnant women, and patients requiring serial and longitudinal follow-up. Fortunately, recent MRI techniques, including ultrashort echo time and zero echo time, are expanding clinical opportunities for pulmonary MRI. With the use of multicoil parallel acquisitions and acceleration methods, these techniques make pulmonary MRI practical for evaluating lung parenchymal and pulmonary vascular diseases. The purpose of this Fleischner Society position paper is to familiarize radiologists and other interested clinicians with these advances in pulmonary MRI and to stratify the Society recommendations for the clinical use of pulmonary MRI into three categories: (a) suggested for current clinical use, (b) promising but requiring further validation or regulatory approval, and (c) appropriate for research investigations. This position paper also provides recommendations for vendors and infrastructure, identifies methods for hypothesis-driven research, and suggests opportunities for prospective, randomized multicenter trials to investigate and validate lung MRI methods.
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Affiliation(s)
- Hiroto Hatabu
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Yoshiharu Ohno
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Warren B Gefter
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Grace Parraga
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Bruno Madore
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Kyung Soo Lee
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Talissa A Altes
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - David A Lynch
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - John R Mayo
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Joon Beom Seo
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Jim M Wild
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Edwin J R van Beek
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Mark L Schiebler
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Hans-Ulrich Kauczor
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
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- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
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Kim TJ, Kim CH, Lee HY, Chung MJ, Shin SH, Lee KJ, Lee KS. Management of incidental pulmonary nodules: current strategies and future perspectives. Expert Rev Respir Med 2019; 14:173-194. [PMID: 31762330 DOI: 10.1080/17476348.2020.1697853] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: Detection and characterization of pulmonary nodules is an important issue, because the process is the first step in the management of lung cancers.Areas covered: Literature review was performed on May 15 2019 by using the PubMed, US National Library of Medicine National Institutes of Health, and the National Center for Biotechnology information. CT features helping identify the druggable mutations and predict the prognosis of malignant nodules were presented. Technical advancements in MRI and PET/CT were introduced for providing functional information about malignant nodules. Advances in various tissue biopsy techniques enabling molecular analysis and histologic diagnosis of indeterminate nodules were also presented. New techniques such as radiomics, deep learning (DL) technology, and artificial intelligence showing promise in differentiating between malignant and benign nodules were summarized. Recently, updated management guidelines for solid and subsolid nodules incidentally detected on CT were described. Risk stratification and prediction models for indeterminate nodules under active investigation were briefly summarized.Expert opinion: Advancement in CT knowledge has led to a better correlation between CT features and genomic alterations or tumor histology. Recent advances like PET/CT, MRI, radiomics, and DL-based approach have shown promising results in the characterization and prognostication of pulmonary nodules.
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Affiliation(s)
- Tae Jung Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Cho Hee Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Ho Yun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Myung Jin Chung
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Sun Hye Shin
- Respiratory and Critical Care Division of Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Kyung Jong Lee
- Respiratory and Critical Care Division of Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
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10
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Zampieri JF, Pacini GS, Zanon M, Altmayer SPL, Watte G, Barros M, Durayski E, Meirelles GDSP, Guimarães MD, Marchiori E, Souza Junior AS, Hochhegger B. Thoracic calcifications on magnetic resonance imaging: correlations with computed tomography. ACTA ACUST UNITED AC 2019; 45:e20180168. [PMID: 31365682 PMCID: PMC6733725 DOI: 10.1590/1806-3713/e20180168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 01/09/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To identify the characteristics of thoracic calcifications on magnetic resonance (MR) imaging, as well as correlations between MR imaging and CT findings. METHODS This was a retrospective study including data on 62 patients undergoing CT scans and MR imaging of the chest at any of seven hospitals in the Brazilian states of Rio Grande do Sul, São Paulo, and Rio de Janeiro between March of 2014 and June of 2016 and presenting with calcifications on CT scans. T1- and T2-weighted MR images (T1- and T2-WIs) were semiquantitatively analyzed, and the lesion-to-muscle signal intensity ratio (LMSIR) was estimated. Differences between neoplastic and non-neoplastic lesions were analyzed. RESULTS Eighty-four calcified lesions were analyzed. Mean lesion density on CT was 367 ± 435 HU. Median LMSIRs on T1- and T2-WIs were 0.4 (interquartile range [IQR], 0.1-0.7) and 0.2 (IQR, 0.0-0.7), respectively. Most of the lesions were hypointense on T1- and T2-WIs (n = 52 [61.9%] and n = 39 [46.4%], respectively). In addition, 19 (22.6%) were undetectable on T1-WIs (LMSIR = 0) and 36 (42.9%) were undetectable on T2-WIs (LMSIR = 0). Finally, 15.5% were hyperintense on T1-WIs and 9.5% were hyperintense on T2-WIs. Median LMSIR was significantly higher for neoplastic lesions than for non-neoplastic lesions. There was a very weak and statistically insignificant negative correlation between lesion density on CT and the following variables: signal intensity on T1-WIs, LMSIR on T1-WIs, and signal intensity on T2-WIs (r = -0.13, p = 0.24; r = -0.18, p = 0.10; and r = -0.16, p = 0.16, respectively). Lesion density on CT was weakly but significantly correlated with LMSIR on T2-WIs (r = -0.29, p < 0.05). CONCLUSIONS Thoracic calcifications have variable signal intensity on T1- and T2-weighted MR images, sometimes appearing hyperintense. Lesion density on CT appears to correlate negatively with lesion signal intensity on MR images.
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Affiliation(s)
- Juliana Fischman Zampieri
- . Laboratório de Pesquisas em Imagens Médicas - LABIMED - Departamento de Radiologia, Pavilhão Pereira Filho, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Gabriel Sartori Pacini
- . Laboratório de Pesquisas em Imagens Médicas - LABIMED - Departamento de Radiologia, Pavilhão Pereira Filho, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Matheus Zanon
- . Laboratório de Pesquisas em Imagens Médicas - LABIMED - Departamento de Radiologia, Pavilhão Pereira Filho, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Stephan Philip Leonhardt Altmayer
- . Laboratório de Pesquisas em Imagens Médicas - LABIMED - Departamento de Radiologia, Pavilhão Pereira Filho, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Programa de Pós-Graduação em Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Guilherme Watte
- . Laboratório de Pesquisas em Imagens Médicas - LABIMED - Departamento de Radiologia, Pavilhão Pereira Filho, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Programa de Pós-Graduação em Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Marcelo Barros
- . Laboratório de Pesquisas em Imagens Médicas - LABIMED - Departamento de Radiologia, Pavilhão Pereira Filho, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Programa de Pós-Graduação em Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Evandra Durayski
- . Programa de Pós-Graduação em Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | | | - Marcos Duarte Guimarães
- . Hospital Heliópolis, São Paulo (SP) Brasil.,. A. C. Camargo Cancer Center, São Paulo (SP) Brasil
| | - Edson Marchiori
- . Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Bruno Hochhegger
- . Laboratório de Pesquisas em Imagens Médicas - LABIMED - Departamento de Radiologia, Pavilhão Pereira Filho, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Programa de Pós-Graduação em Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
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11
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Meier-Schroers M, Homsi R, Schild HH, Thomas D. Lung cancer screening with MRI: characterization of nodules with different non-enhanced MRI sequences. Acta Radiol 2019; 60:168-176. [PMID: 29792040 DOI: 10.1177/0284185118778870] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is increased interest in pulmonary magnetic resonance imaging (MRI) as a radiation-free alternative to computed tomography (CT) for lung cancer screening. PURPOSE To analyze MRI characteristics of pulmonary nodules with different non-enhanced sequences. MATERIAL AND METHODS Eighty-two participants of a lung cancer screening were included. MRI datasets of 32 individuals with 46 different nodules ≥ 6 mm were prospectively evaluated together with 50 controls by two readers. Acquired sequences were T2- short tau inversion recovery (STIR), T2, balanced steady-state free precession (bSSFP), 3D-T1, and diffusion-weighted imaging (DWI). Each sequence was randomly and separately viewed blinded to low-dose CT (LDCT). Size, shape, and contrast of nodules were evaluated on each sequence and then correlated with LDCT and histopathology. RESULTS All eight carcinomas were detected by T2-STIR, T2, and bSSFP, and 7/8 by 3D-T1. Contrast was significantly higher for malignant nodules on all sequences. The highest contrast ratio between malignant and benign nodules was provided by T2-STIR. Of eight carcinomas, seven showed restricted diffusion. Size measurement correlated significantly between MRI and LDCT. Sensitivity/specificity for nodules ≥ 6 mm was 85-89%/92-94% for T2-STIR, 80-87%/93-96% for T2, 65-70%/96-98% for bSSFP, and 63-67%/96-100% for 3D-T1. Seven of eight subsolid nodules were visible on T2-sequences with significantly lower lesion contrast compared to solid nodules. Two of eight subsolid nodules were detected by bSFFP, none by 3D-T1. All three calcified nodules were detected by 3D-T1, one by bSSFP, and none by T2-sequences. CONCLUSION Malignant as well as calcified and subsolid nodules seem to have distinctive characteristics on different MRI sequences. T2-imaging was most suitable for the detection of nodules ≥ 6 mm.
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Affiliation(s)
| | - Rami Homsi
- Department of Radiology, University of Bonn, Bonn, Germany
| | | | - Daniel Thomas
- Department of Radiology, University of Bonn, Bonn, Germany
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Galgano S, Viets Z, Fowler K, Gore L, Thomas JV, McNamara M, McConathy J. Practical Considerations for Clinical PET/MR Imaging. PET Clin 2018; 13:97-112. [PMID: 29157390 DOI: 10.1016/j.cpet.2017.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Clinical PET/MR imaging is currently performed at a number of centers around the world as part of routine standard of care. This article focuses on issues and considerations for a clinical PET/MR imaging program, focusing on routine standard-of-care studies. Although local factors influence how clinical PET/MR imaging is implemented, the approaches and considerations described here intend to apply to most clinical programs. PET/MR imaging provides many more options than PET/computed tomography with diagnostic advantages for certain clinical applications but with added complexity. A recurring theme is matching the PET/MR imaging protocol to the clinical application to balance diagnostic accuracy with efficiency.
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Affiliation(s)
- Samuel Galgano
- Department of Radiology, University of Alabama at Birmingham (UAB), 619 19th Street South, Birmingham, AL 35249, USA
| | - Zachary Viets
- Department of Radiology, Washington University in St Louis, 510 South Kingshighway Boulevard, St. Louis, MO 63110, USA
| | - Kathryn Fowler
- Department of Radiology, Washington University in St Louis, 510 South Kingshighway Boulevard, St. Louis, MO 63110, USA
| | - Lael Gore
- Department of Radiology, University of Alabama at Birmingham (UAB), 619 19th Street South, Birmingham, AL 35249, USA
| | - John V Thomas
- Department of Radiology, University of Alabama at Birmingham (UAB), 619 19th Street South, Birmingham, AL 35249, USA
| | - Michelle McNamara
- Department of Radiology, University of Alabama at Birmingham (UAB), 619 19th Street South, Birmingham, AL 35249, USA
| | - Jonathan McConathy
- Department of Radiology, University of Alabama at Birmingham (UAB), 619 19th Street South, Birmingham, AL 35249, USA.
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Ohno Y, Kauczor HU, Hatabu H, Seo JB, van Beek EJR. MRI for solitary pulmonary nodule and mass assessment: Current state of the art. J Magn Reson Imaging 2018; 47:1437-1458. [PMID: 29573050 DOI: 10.1002/jmri.26009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/26/2018] [Indexed: 12/14/2022] Open
Abstract
Since the clinical introduction of magnetic resonance imaging (MRI), the chest has been one of its most challenging applications, and many physicists and radiologists have tried since the 1980s to use MR for assessment of different lung diseases as well as mediastinal and pleural diseases. Since then, however, technical advances in sequencing, scanners, and coils, adaptation of parallel imaging techniques, utilization of contrast media, and development of postprocessing tools have been reported by many basic and clinical researchers. As a result, state-of-the-art thoracic MRI is now substituted for traditional imaging techniques and/or plays a complementary role in the management of patients with various chest diseases, and especially in the detection of pulmonary nodules and in thoracic oncology. In addition, MRI has continued to be developed to help overcome the limitations of computed tomography (CT) and nuclear medicine examinations. It can currently provide not only morphological, but also functional, physiological, pathophysiological, and molecular information at 1.5T with a gradual shift from 1.5T to 3T MR systems. In this review, we focus on these recent advances in MRI for pulmonary nodule detection and pulmonary nodule and mass evaluation by using noncontrast-enhanced and contrast-enhanced techniques as well as new molecular imaging methods such as chemical exchange saturation transfer imaging for a comparison with other modalities such as single or multidetector row CT, 18F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET), and/or PET/CT. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1437-1458.
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Affiliation(s)
- Yoshiharu Ohno
- Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.,Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Medical Center Heidelberg, Translational Lung Research Center/German Center of Lung Research, Heidelberg, Germany
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital, Boston and Harvard Medical School, Boston, Massachusetts, USA
| | - Joon Beom Seo
- Department of Radiology, University of Ulsan College of Medicine, Seoul, Korea.,Division of Cardiothoracic Radiology, Department of Radiology, Asan Medical Center, Seoul, Korea
| | - Edwin J R van Beek
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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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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Galgano S, Viets Z, Fowler K, Gore L, Thomas JV, McNamara M, McConathy J. Practical Considerations for Clinical PET/MR Imaging. Magn Reson Imaging Clin N Am 2017; 25:281-296. [DOI: 10.1016/j.mric.2016.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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16
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Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET)/MRI for Lung Cancer Staging. J Thorac Imaging 2016; 31:215-27. [DOI: 10.1097/rti.0000000000000210] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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17
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Cieszanowski A, Lisowska A, Dabrowska M, Korczynski P, Zukowska M, Grudzinski IP, Pacho R, Rowinski O, Krenke R. MR Imaging of Pulmonary Nodules: Detection Rate and Accuracy of Size Estimation in Comparison to Computed Tomography. PLoS One 2016; 11:e0156272. [PMID: 27258047 PMCID: PMC4892605 DOI: 10.1371/journal.pone.0156272] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 05/11/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The aims of this study were to assess the sensitivity of various magnetic resonance imaging (MRI) sequences for the diagnosis of pulmonary nodules and to estimate the accuracy of MRI for the measurement of lesion size, as compared to computed tomography (CT). METHODS Fifty patients with 113 pulmonary nodules diagnosed by CT underwent lung MRI and CT. MRI studies were performed on 1.5T scanner using the following sequences: T2-TSE, T2-SPIR, T2-STIR, T2-HASTE, T1-VIBE, and T1-out-of-phase. CT and MRI data were analyzed independently by two radiologists. RESULTS The overall sensitivity of MRI for the detection of pulmonary nodules was 80.5% and according to nodule size: 57.1% for nodules ≤4mm, 75% for nodules >4-6mm, 87.5% for nodules >6-8mm and 100% for nodules >8mm. MRI sequences yielded following sensitivities: 69% (T1-VIBE), 54.9% (T2-SPIR), 48.7% (T2-TSE), 48.7% (T1-out-of-phase), 45.1% (T2-STIR), 25.7% (T2-HASTE), respectively. There was very strong agreement between the maximum diameter of pulmonary nodules measured by CT and MRI (mean difference -0.02 mm; 95% CI -1.6-1.57 mm; Bland-Altman analysis). CONCLUSIONS MRI yielded high sensitivity for the detection of pulmonary nodules and enabled accurate assessment of their diameter. Therefore it may be considered an alternative to CT for follow-up of some lung lesions. However, due to significant number of false positive diagnoses, it is not ready to replace CT as a tool for lung nodule detection.
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Affiliation(s)
- Andrzej Cieszanowski
- 2 Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland
- Maria Skłodowska-Curie Memorial Cancer Center, Institute of Oncology, Warsaw, Poland
- * E-mail:
| | - Antonina Lisowska
- 2 Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland
| | - Marta Dabrowska
- Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Korczynski
- Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Zukowska
- 2 Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland
| | - Ireneusz P. Grudzinski
- Department of Toxicology, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland
| | - Ryszard Pacho
- 2 Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland
| | - Olgierd Rowinski
- 2 Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland
| | - Rafal Krenke
- Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland
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Kumar S, Liney G, Rai R, Holloway L, Moses D, Vinod SK. Magnetic resonance imaging in lung: a review of its potential for radiotherapy. Br J Radiol 2016; 89:20150431. [PMID: 26838950 DOI: 10.1259/bjr.20150431] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
MRI has superior soft-tissue definition compared with existing imaging modalities in radiation oncology; this has the added benefit of functional as well as anatomical imaging. This review aimed to evaluate the current use of MRI for lung cancer and identify the potential of a MRI protocol for lung radiotherapy (RT). 30 relevant studies were identified. Improvements in MRI technology have overcome some of the initial limitations of utilizing MRI for lung imaging. A number of commercially available and novel sequences have shown image quality to be adequate for the detection of pulmonary nodules with the potential for tumour delineation. Quantifying tumour motion is also feasible and may be more representative than that seen on four-dimensional CT. Functional MRI sequences have shown correlation with flu-deoxy-glucose positron emission tomography (FDG-PET) in identifying malignant involvement and treatment response. MRI can also be used as a measure of pulmonary function. While there are some limitations for the adoption of MRI in RT-planning process for lung cancer, MRI has shown the potential to compete with both CT and PET for tumour delineation and motion definition, with the added benefit of functional information. MRI is well placed to become a significant imaging modality in RT for lung cancer.
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Affiliation(s)
- Shivani Kumar
- 1 South Western Clinical School, School of Medicine, University of New South Wales, Liverpool, NSW, Australia.,2 Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Liverpool, NSW, Australia.,3 Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Gary Liney
- 1 South Western Clinical School, School of Medicine, University of New South Wales, Liverpool, NSW, Australia.,2 Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Liverpool, NSW, Australia.,3 Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.,4 Centre for Medical Radiation Physics, University of Wollongong, Liverpool, NSW, Australia
| | - Robba Rai
- 2 Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Liverpool, NSW, Australia.,3 Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Lois Holloway
- 1 South Western Clinical School, School of Medicine, University of New South Wales, Liverpool, NSW, Australia.,2 Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Liverpool, NSW, Australia.,3 Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.,4 Centre for Medical Radiation Physics, University of Wollongong, Liverpool, NSW, Australia.,5 Institute of Medical Physics, School of Physics, University of Sydney, Sydney, NSW, Australia
| | - Daniel Moses
- 1 South Western Clinical School, School of Medicine, University of New South Wales, Liverpool, NSW, Australia.,6 Department of Medical Imaging, Northern Hospital Network, Sydney, NSW, Australia.,7 Western Sydney University, Penrith, NSW, Australia
| | - Shalini K Vinod
- 1 South Western Clinical School, School of Medicine, University of New South Wales, Liverpool, NSW, Australia.,2 Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Liverpool, NSW, Australia.,7 Western Sydney University, Penrith, NSW, Australia
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Meier-Schroers M, Kukuk G, Homsi R, Skowasch D, Schild HH, Thomas D. MRI of the lung using the PROPELLER technique: Artifact reduction, better image quality and improved nodule detection. Eur J Radiol 2015; 85:707-13. [PMID: 26971412 DOI: 10.1016/j.ejrad.2015.12.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the benefit of the PROPELLER technique (Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction, MultiVane, MV) for MR imaging of the lung. MATERIALS AND METHODS 30 Participants of a lung cancer screening program were recruited for the comparison of T2-MV and T2-Fast Spin Echo (FSE) sequences at 1.5T. Two readers evaluated artifacts, image quality, and pulmonary lesions. Artifacts and image quality were rated using a four-point scale. Lesion detection was correlated to low-dose computed tomography (CT). Wilcoxon rank-test for ratings of artifacts and image quality, sensitivity and specificity values for lesion detection, and Cohen's kappa for inter-rater agreement were used. RESULTS The MV sequence showed less pulsation and motion artifacts, and higher image quality (p=0.001 for R1, p=0.002 for R2) than FSE (p<0.001 for both readers, R1 and R2). Inter-rater agreement was excellent for lesion detection (0.84-0.95) and good to excellent for artifacts and image quality (0.66-0.84). 17 patients had lesions <8mm, and 7 had lesions >8mm as seen on CT. For R1 and R2, the MV sequence allowed for higher detection rates of pulmonary lesions <8mm with a sensitivity of 56% (R1) and 59% (R2); the FSE sequence achieved 50% (R1) and 53% (R2). Specificity was also higher for MV with 94% (R1) and 83% (R2) compared to 78% (R1) and 76% (R2). Lesions >8mm were detected with a sensitivity of 100% by both readers on both MV and FSE images. For both readers, specificity for larger lesions was higher on MV images with 100% compared to 96%. CONCLUSION The superior image quality and the very robust artifact reduction make MV a promising technique for MRI of the lung compared to FSE, especially since it is not requiring breathholds. Moreover, MV allows for improved lesion detection.
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Affiliation(s)
| | - Guido Kukuk
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
| | - Rami Homsi
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
| | - Dirk Skowasch
- Department of Internal Medicine II, Cardiology, Pneumology and Angiology, University of Bonn, Germany.
| | - Hans Heinz Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
| | - Daniel Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
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Abstract
PET/MRI is a hybrid imaging modality that is gaining clinical interest with the first Food and Drug Administration-approved simultaneous imaging system recently added to the clinical armamentarium. Several advanced PET/MRI applications, such as high-resolution anatomic imaging, diffusion-weighted imaging, motion correction, and cardiac imaging, show great potential for clinical use. The purpose of this article is to highlight several advanced PET/MRI applications through case examples and review of the current literature.
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Coolen J, De Keyzer F, Nafteux P, De Wever W, Dooms C, Vansteenkiste J, Derweduwen A, Roebben I, Verbeken E, De Leyn P, Van Raemdonck D, Nackaerts K, Dymarkowski S, Verschakelen J. Malignant Pleural Mesothelioma: Visual Assessment by Using Pleural Pointillism at Diffusion-weighted MR Imaging. Radiology 2015; 274:576-84. [DOI: 10.1148/radiol.14132111] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Heye T, Sommer G, Miedinger D, Bremerich J, Bieri O. Ultrafast 3D balanced steady-state free precession MRI of the lung: Assessment of anatomic details in comparison to low-dose CT. J Magn Reson Imaging 2014; 42:602-9. [PMID: 25545835 DOI: 10.1002/jmri.24836] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 12/11/2014] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To evaluate the anatomical details offered by a new single breath-hold ultrafast 3D balanced steady-state free precession (uf-bSSFP) sequence in comparison to low-dose chest computed tomography (CT). MATERIALS AND METHODS This was an Institutional Review Board (IRB)-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant prospective study. A total of 20 consecutive patients enrolled in a lung cancer screening trial underwent same-day low-dose chest CT and 1.5T MRI. The presence of pulmonary nodules and anatomical details on 1.9 mm isotropic uf-bSSFP images was compared to 2 mm lung window reconstructions by two readers. The number of branching points on six predefined pulmonary arteries and the distance between the most peripheral visible vessel segment to the pleural surface on thin slices and 50 mm maximum intensity projections (MIP) were assessed. Image quality and sharpness of the pulmonary vasculature were rated on a 5-point scale. RESULTS The uf-bSSFP detection rate of pulmonary nodules (32 nodules visible on CT and MRI, median diameter 3.9 mm) was 45.5% with 21 false-positive findings (pooled data of both readers). Uf-bSSFP detected 71.2% of branching points visible on CT data. The mean distance between peripheral vasculature and pleural surface was 13.0 ± 4.2 mm (MRI) versus 8.5 ± 3.3 mm (CT) on thin slices and 8.6 ± 3.9 mm (MRI) versus 4.6 ± 2.5 mm (CT) on MIPs. Median image quality and sharpness were rated 4 each. CONCLUSION Although CT is superior to MRI, uf-bSSFP imaging provides good anatomical details with sufficient image quality and sharpness obtainable in a single breath-hold covering the entire chest.
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Affiliation(s)
- Tobias Heye
- Cardiothoracic Section, Department of Radiology and Nuclear Medicine, University Hospital Basel, Switzerland
| | - Gregor Sommer
- Cardiothoracic Section, Department of Radiology and Nuclear Medicine, University Hospital Basel, Switzerland
| | | | - Jens Bremerich
- Cardiothoracic Section, Department of Radiology and Nuclear Medicine, University Hospital Basel, Switzerland
| | - Oliver Bieri
- MR Physics, Department of Radiology and Nuclear Medicine, University Hospital Basel, Switzerland
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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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Shin KE, Yi CA, Kim TS, Lee HY, Choi YS, Kim HK, Kim J. Diffusion-weighted MRI for distinguishing non-neoplastic cysts from solid masses in the mediastinum: problem-solving in mediastinal masses of indeterminate internal characteristics on CT. Eur Radiol 2013; 24:677-84. [DOI: 10.1007/s00330-013-3054-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/29/2013] [Accepted: 10/08/2013] [Indexed: 11/29/2022]
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Characterisation of solitary pulmonary lesions combining visual perfusion and quantitative diffusion MR imaging. Eur Radiol 2013; 24:531-41. [PMID: 24173597 DOI: 10.1007/s00330-013-3053-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/14/2013] [Accepted: 10/08/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of dynamic contrast-enhanced (DCE) magnetic resonance (MR) and diffusion-weighted imaging (DWI) sequences for defining benignity or malignancy of solitary pulmonary lesions (SPL). METHODS First, 54 consecutive patients with SPL, clinically staged (CT and PET or integrated PET-CT) as N0M0, were included in this prospective study. An additional 3-Tesla MR examination including DCE and DWI was performed 1 day before the surgical procedure. Histopathology of the surgical specimen served as the standard of reference. Subsequently, this functional method of SPL characterisation was validated with a second cohort of 54 patients. RESULTS In the feasibility group, 11 benign and 43 malignant SPL were included. Using the combination of conventional MR sequences with visual interpretation of DCE-MR curves resulted in a sensitivity, specificity and accuracy of 100%, 55% and 91%, respectively. These results can be improved by DWI (with a cut-off value of 1.52 × 10(-3) mm(2)/s for ADChigh) leading to a sensitivity, specificity and accuracy of 98%, 82% and 94%, respectively. In the validation group these results were confirmed. CONCLUSION Visual DCE-MR-based curve interpretation can be used for initial differentiation of benign from malignant SPL, while additional quantitative DWI-based interpretation can further improve the specificity. KEY POINTS • Magnetic resonance imaging is increasingly being used to help differentiate lung lesions. • Solitary pulmonary lesions (SPL) are accurately characterised by combining DCE-MRI and DWI. • Visual DCE-MRI assessment facilitates the diagnostic throughput in patients with SPL. • DWI provides additional information in inconclusive DCE-MRI (type B pattern).
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Hernandes MDA, Semelka RC, Elias Júnior J, Bamrungchart S, Dale BM, Stallings C. Whole-body MRI: comprehensive evaluation on a 48-channel 3T MRI system in less than 40 minutes. Preliminary results. Radiol Bras 2012. [DOI: 10.1590/s0100-39842012000600007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To evaluate a comprehensive MRI protocol that investigates for cancer, vascular disease, and degenerative/inflammatory disease from the head to the pelvis in less than 40 minutes on a new generation 48-channel 3T system. MATERIALS AND METHODS: All MR studies were performed on a 48-channel 3T MR scanner. A 20-channel head/neck coil, two 18-channel body arrays, and a 32-channel spine array were employed. A total of 4 healthy individuals were studied. The designed protocol included a combination of single-shot T2-weighted sequences, T1-weighted 3D gradient-echo pre- and post-gadolinium. All images were retrospectively evaluated by two radiologists independently for overall image quality. RESULTS: The image quality for cancer was rated as excellent in the liver, pancreas, kidneys, lungs, pelvic organs, and brain, and rated as fair in the colon and breast. For vascular diseases ratings were excellent in the aorta, major branch vessel origins, inferior vena cava, portal and hepatic veins, rated as good in pulmonary arteries, and as poor in the coronary arteries. For degenerative/inflammatory diseases ratings were excellent in the brain, liver and pancreas. The inter-observer agreement was excellent. CONCLUSION: A comprehensive and time efficient screening for important categories of disease processes may be achieved with high quality imaging in a new generation 48-channel 3T system.
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Lin WC, Chang YC, Chang CY, Cheng YC, Hwang JJ. Primary lung cancers <1 cm found with MR screening appeared larger with half-Fourier sequences than with three-dimensional acquisition techniques. Clin Imaging 2012; 36:739-45. [DOI: 10.1016/j.clinimag.2012.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 12/27/2011] [Accepted: 02/08/2012] [Indexed: 12/21/2022]
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Coolen J, De Keyzer F, Nafteux P, De Wever W, Dooms C, Vansteenkiste J, Roebben I, Verbeken E, De Leyn P, Van Raemdonck D, Nackaerts K, Dymarkowski S, Verschakelen J. Malignant Pleural Disease: Diagnosis by Using Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging—Initial Experience. Radiology 2012; 263:884-92. [DOI: 10.1148/radiol.12110872] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Heye T, Ley S, Heussel CP, Dienemann H, Kauczor HU, Hosch W, Libicher M. Detection and size of pulmonary lesions: how accurate is MRI? A prospective comparison of CT and MRI. Acta Radiol 2012; 53:153-60. [PMID: 22287146 DOI: 10.1258/ar.2011.110445] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although CT is the modality of choice for morphological lung imaging, an increasing proportion of chest imaging is performed by MRI due to the utilization of whole-body MRI. Therefore, the diagnostic performance of MRI in reliably detecting pulmonary lesions should be established. PURPOSE To investigate the detection rate of pulmonary lesions by MRI that can be expected in a clinical setting and to assess the accuracy of lesion measurement by MRI compared to CT. MATERIAL AND METHODS Twenty-eight patients (median age 66 years) with indication for CT imaging due to suspected thoracic malignancy were prospectively included. Chest MRI performed on the same day as CT, comprised unenhanced TrueFisp, ecg-gated T2-weighted HASTE, T1-weighted VIBE, and contrast-enhanced T1-weighted, fat-saturated VIBE sequences. MR sequences were evaluated for lesion detection by two readers independently and measurement of lesion size was performed. MR findings were correlated with CT. RESULTS One hundred and eight pulmonary lesions (20 thoracic malignancies, 88 lung nodules) were detected by CT in 26 patients. Lesions were ruled out in two patients. All thoracic malignancies were identified by MRI with strong correlation (r = 0.97-0.99; P < 0.01) in lesion size measurement compared to CT. Unenhanced, T1-weighted VIBE correctly classified 94% of thoracic malignancies into T-stages. Contrast-enhanced, T1-weighted VIBE performed best in identifying 36% of lung nodules, 40% were detected combining unenhanced and contrast-enhanced T1-weighted VIBE. Detection rate increased to 65% for the combined sequences regarding lesions ≥5 mm. Lesion size measurement by all MR sequences strongly correlated with CT (r = 0.96-0.97; P = 0.01). CONCLUSION MRI is as accurate as CT in detection and size measurement of primary thoracic malignancies >1 cm in diameter. If a lung lesion is detected by MRI, it is a reliable finding and its measurement is accurate. CT remains superior in detecting small lung nodules (<6 mm). Detection rate of MRI for small lesions is improved using a multi-sequence protocol including contrast administration.
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Affiliation(s)
- Tobias Heye
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | - Sebastian Ley
- Division of Cardiothoracic Imaging University Health Network, Mount Sinai Hospital and Women's College Hospital University of Toronto, Canada
| | - Claus Peter Heussel
- Department of Diagnostic and Interventional Radiology, Thoraxklinik, University of Heidelberg, Germany
| | - Hendrik Dienemann
- Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | - Waldemar Hosch
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | - Martin Libicher
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology, Diakonie Klinikum, Schwäbisch Hall, Germany
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Chien CC, Zhang G, Hwu Y, Liu P, Yue W, Sun J, Li Y, Xue H, Xu LX, Wang CH, Chen N, Lu CH, Lee TK, Yang YC, Lu YT, Ching YT, Shih TF, Yang PC, Je JH, Margaritondo G. Detecting small lung tumors in mouse models by refractive-index microradiology. Anal Bioanal Chem 2011; 401:827-35. [DOI: 10.1007/s00216-011-5117-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 05/10/2011] [Accepted: 05/16/2011] [Indexed: 11/28/2022]
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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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Chen W, Jian W, Li HT, Li C, Zhang YK, Xie B, Zhou DQ, Dai YM, Lin Y, Lu M, Huang XQ, Xu CX, Chen L. Whole-body diffusion-weighted imaging vs. FDG-PET for the detection of non-small-cell lung cancer. How do they measure up? Magn Reson Imaging 2010; 28:613-20. [PMID: 20418042 DOI: 10.1016/j.mri.2010.02.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 12/04/2009] [Accepted: 02/08/2010] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare the diagnostic efficacy of whole-body diffusion-weighted imaging (WB-DWI) and [18F] fluoro-2-D-glucose PET/CT(FDG-PET/CT)for assessment of non-small cell lung cancer (NSCLC) patients. MATERIALS AND METHODS A group of 56 patients (21 female, 35 male; 35-76 years) with NSCLC proved by pathologic examination or follow-up imaging findings was set as reference standards, and all patients underwent both WB-DWI at 1.5T (MAGNETOM Avanto) and PET/CT (Biograph 16). For WB-DWI, a free breathing diffusion-weighted single-shot spin-echo epi-sequence in five-stations (head-neck, thorax, abdomen, pelvis-thigh) was used. Each station-series contained 30 contiguous axial slices. Imaging parameters: FOV 360x360 mm, matrix size 128x80. B-values: 0 and 1000 s/mm(2) applied along x, y and z, 5 averages, acquisition time: 2.23 min/series, total: 11.55 min. The efficacy of WB-DWI and PET/CT were determined in a blinded reading by two radiologists and two nuclear medicine physicians using pathology and size change during follow up exams as the reference standard. RESULTS Primary tumors (n=56 patients) were correctly detected in 56 (100%) patients by both PET/CT and WB-DWI. Ninety-six lymph nodes metastases were determined with pathologic and follow-up examinations. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) being for lymph node metastases: 91%, 90%, 90%, 96%, 80% with WB-DWI and 98%, 97%, 97%, 99%, 93% with PET-CT, other metastases: 90%, 95%, 92%, 97%, 83% with WB-DWI and 98%, 100%, 98%, 100%, 95% with PET-CT). Differences in the accuracy of lymph node metastasis detection between PET/CT and WB-DWI (P=.031) were significant. The differences were not statistically significant for detection of other metastases. CONCLUSIONS WB-DWI is a feasible clinical technique for the assessment of NSCLC, lymph nodes and metastastic spread with high sensitivity and accuracy, but it was limited in the evaluation of neck lymph node metastases and small metastastic lung nodules.
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Affiliation(s)
- Wei Chen
- Department of Radiology, Southwest Hospital, The Third Military Medical University, Chongqing, China
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Comparison of STIR turbo SE imaging and diffusion-weighted imaging of the lung: capability for detection and subtype classification of pulmonary adenocarcinomas. Eur Radiol 2009; 20:790-800. [PMID: 19763578 DOI: 10.1007/s00330-009-1615-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 07/11/2009] [Accepted: 08/13/2009] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the diagnostic performance of diffusion-weighted imaging (DWI) for detection and subtype classification in pulmonary adenocarcinomas through comparison with short TI inversion recovery turbo spin-echo imaging sequence (STIR). METHODS Thirty-two patients (mean age, 65.2 years) with 33 adenocarcinomas (mean diameter, 27.6 mm) were enrolled in this study. The detection rates of both sequences were compared. The ADC values on DWI and the contrast ratio (CR) between cancer and muscle on STIR were measured and those were compared across subtype classifications. Finally, ROC-based positive tests were performed to differentiate subtype classifications, and differentiation capabilities were compared. RESULTS The DWI detection rate [85% (28/33)] was significantly lower than that of STIR [100% (33/33), P < 0.05]. The ADC values showed no significant difference regarding subtype classification; however, the CRs of bronchio-alveolar carcinomas (BACs) were significantly lower than those of other types (P < 0.05). When threshold values for differentiating BACs from others were adapted, the sensitivity and accuracy of DWI were significantly lower than those of STIR (P < 0.05). For differentiating adenocarcinomas with mixed subtypes from those with no BA component, there were no significant differences between the two sequences. CONCLUSION STIR is more sensitive for detection and subtype classification than DWI.
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Mediastinal Nodes in Patients with Non–Small Cell Lung Cancer: MRI Findings with PET/CT and Pathologic Correlation. AJR Am J Roentgenol 2009; 193:813-21. [DOI: 10.2214/ajr.08.2083] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Yi CA, Shin KM, Lee KS, Kim BT, Kim H, Kwon OJ, Choi JY, Chung MJ. Non-small cell lung cancer staging: efficacy comparison of integrated PET/CT versus 3.0-T whole-body MR imaging. Radiology 2008; 248:632-42. [PMID: 18552311 DOI: 10.1148/radiol.2482071822] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To compare prospectively the diagnostic efficacies of integrated positron emission tomography (PET)/computed tomography (CT) and 3.0-T whole-body magnetic resonance (MR) imaging for determining TNM stages in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS Institutional review board approval and informed consent were obtained. The study included 165 patients (125 men, 40 women; mean age, 61 years) with NSCLC proved at pathologic examination who underwent both unenhanced PET/CT and whole-body MR imaging. Pathologic findings for T (n = 123) and N (n = 150) staging and pathologic or follow-up imaging findings (n = 154) for M staging were reference standards. The efficacies of PET/CT and whole-body MR imaging for lung cancer staging were compared by using the McNemar test. RESULTS Primary tumors (n = 123 patients) were correctly staged in 101 (82%) patients at PET/CT and in 106 (86%) patients at whole-body MR imaging (P = .263). N stages (n = 150 patients) were correctly determined in 105 (70%) patients at PET/CT and in 102 (68%) patients at whole-body MR imaging (P = .880). Thirty-one (20%) of 154 patients had metastatic lesions. Accuracy for detecting metastases was 86% (133 of 154 patients) at PET/CT, and that at whole-body MR imaging was 86% (132 of 154 patients) (P > .99). Although the differences were not statistically significant, whole-body MR imaging was more useful for detecting brain and hepatic metastases, whereas PET/CT was more useful for detecting lymph node and soft-tissue metastases. CONCLUSION Both PET/CT and 3.0-T whole-body MR imaging appear to provide acceptable accuracy and comparable efficacy for NSCLC staging, but for M-stage determination, each modality has its own advantages.
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Affiliation(s)
- Chin A Yi
- Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, Seoul, Korea
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3-T MRI for differentiating inflammation- and fibrosis-predominant lesions of usual and nonspecific interstitial pneumonia: comparison study with pathologic correlation. AJR Am J Roentgenol 2008; 190:878-85. [PMID: 18356432 DOI: 10.2214/ajr.07.2833] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of our study was to evaluate the utility of 3-T MRI of the lung for differentiating inflammation- and fibrosis-predominant lesions in the usual and nonspecific types of interstitial pneumonia. SUBJECTS AND METHODS The subjects were 26 patients (10 men, 16 women; mean age, 57 +/- 9 [SD] years; 16 with nonspecific interstitial pneumonia; 10 with usual interstitial pneumonia) who underwent 3-T MRI of the lung and surgical biopsy. A total of 54 biopsy sites were classified histopathologically into two groups: inflammation predominant and fibrosis predominant. After a T2-weighted triple-inversion black blood turbo spin-echo (TSE) sequence, dynamic MRI was performed with a T1-weighted 3D turbo field-echo sequence (coronal images with 2.5-mm slice thickness) before and 1, 3, 5, and 10 minutes after i.v. contrast injection. The chi-square test was used to compare differences in signal intensity on T2-weighted triple-inversion black blood TSE MR images and visually assessed enhancement patterns at dynamic MRI for the inflammation- and fibrosis-predominant sites. RESULTS Inflammation-predominant specimens were obtained from 31% (17 of 54) of the biopsy sites. Inflammation-predominant biopsy sites had an early enhancement pattern (82%, 14 of 17 sites, p < 0.001) on dynamic studies and high signal intensity (53%, nine of 17 sites, p = 0.001) on T2-weighted triple-inversion black blood TSE images. CONCLUSION Multiphase dynamic enhancement studies with a turbo field-echo sequence and T2-weighted triple-inversion black blood TSE images on 3-T MRI appear to be useful for differentiating inflammation- and fibrosis-predominant lesions.
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Godelman A, Haramati LB. MR Imaging in Diagnosis and Staging of Pulmonary Carcinoma. Magn Reson Imaging Clin N Am 2008; 16:309-17, ix. [DOI: 10.1016/j.mric.2008.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fujimoto K. Usefulness of contrast-enhanced magnetic resonance imaging for evaluating solitary pulmonary nodules. Cancer Imaging 2008; 8:36-44. [PMID: 18331971 PMCID: PMC2267694 DOI: 10.1102/1470-7330.2008.0009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Evaluation of solitary pulmonary nodules (SPNs) poses a challenge to radiologists. Chest computed tomography (CT) is considered the standard technique for assessing morphologic findings and intrathoracic spread of an SPN. Although the clinical role of magnetic resonance imaging (MRI) for SPNs remains limited, considerable experience has been gained with MRI of thoracic diseases. Dynamic MRI and dynamic CT are useful for differentiating between malignant and benign SPNs (especially tuberculomas and hamartomas). Furthermore, dynamic MRI is useful for assessing tumor vascularity, interstitium, and vascular endothelial growth factor expression, and for predicting survival outcome among patients with peripheral pulmonary carcinoma. These advantages make dynamic MRI a promising method and a potential biomarker for characterizing tumor response to anti-angiogenic treatment as well as for predicting survival outcomes after treatment.
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Affiliation(s)
- Kiminori Fujimoto
- Department of Radiology, Kurume University School of Medicine and Center for Diagnostic Imaging, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011 Japan.
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