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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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Glandorf J, Vogel-Claussen J. Incidental pulmonary nodules - current guidelines and management. ROFO-FORTSCHR RONTG 2024; 196:582-590. [PMID: 38065544 DOI: 10.1055/a-2185-8714] [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: 05/24/2024]
Abstract
BACKGROUND Due to the greater use of high-resolution cross-sectional imaging, the number of incidental pulmonary nodules detected each year is increasing. Although the vast majority of incidental pulmonary nodules are benign, many early lung carcinomas could be diagnosed with consistent follow-up. However, for a variety of reasons, the existing recommendations are often not implemented correctly. Therefore, potential for improvement with respect to competence, communication, structure, and process is described. METHODS This article presents the recommendations for incidental pulmonary nodules from the current S3 guideline for lung cancer (July 2023). The internationally established recommendations (BTS guidelines and Fleischner criteria) are compared and further studies on optimized management were included after a systematic literature search in PubMed. RESULTS AND CONCLUSION In particular, AI-based software solutions are promising, as they can be used in a support capacity on several levels at once and can lead to simpler and more automated management. However, to be applicable in routine clinical practice, software must fit well into the radiology workflow and be integrated. In addition, "Lung Nodule Management" programs or clinics that follow a high-quality procedure for patients with incidental lung nodules or nodules detected by screening have been established in the USA. Similar structures might also be implemented in Germany in a future screening program in which patients with incidental pulmonary nodules could be included. KEY POINTS · Incidental pulmonary nodules are common but are often not adequately managed. · The updated S3 guideline for lung cancer now includes recommendations for incidental pulmonary nodules. · Competence, communication, structure, and process levels offer significant potential for improvement. CITATION FORMAT · Glandorf J, Vogel-Claussen J, . Incidental pulmonary nodules - current guidelines and management. Fortschr Röntgenstr 2024; 196: 582 - 590.
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Affiliation(s)
- Julian Glandorf
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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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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Wang Z, Ramasawmy R, Feng X, Campbell-Washburn AE, Mugler JP, Meyer CH. Concomitant magnetic-field compensation for 2D spiral-ring turbo spin-echo imaging at 0.55T and 1.5T. Magn Reson Med 2023; 90:552-568. [PMID: 37036033 PMCID: PMC10578525 DOI: 10.1002/mrm.29663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE To develop 2D turbo spin-echo (TSE) imaging using annular spiral rings (abbreviated "SPRING-RIO TSE") with compensation of concomitant gradient fields and B0 inhomogeneity at both 0.55T and 1.5T for fast T2 -weighted imaging. METHODS Strategies of gradient waveform modifications were implemented in SPRING-RIO TSE for compensation of self-squared concomitant gradient terms at the TE and across echo spacings, along with reconstruction-based corrections to simultaneously compensate for the residual concomitant gradient and B0 field induced phase accruals along the readout. The signal pathway disturbance caused by time-varying and spatially dependent concomitant fields was simulated, and echo-to-echo phase variations before and after sequence-based compensation were compared. Images from SPRING-RIO TSE with no compensation, with compensation, and Cartesian TSE were also compared via phantom and in vivo acquisitions. RESULTS Simulation showed how concomitant fields affected the signal evolution with no compensation, and both simulation and phantom studies demonstrated the performance of the proposed sequence modifications, as well as the readout off-resonance corrections. Volunteer data showed that after full correction, the SPRING-RIO TSE sequence achieved high image quality with improved SNR efficiency (15%-20% increase), and reduced RF SAR (˜50% reduction), compared to the standard Cartesian TSE, presenting potential benefits, especially in regaining SNR at low-field (0.55T). CONCLUSION Implementation of SPRING-RIO TSE with concomitant field compensation was tested at 0.55T and 1.5T. The compensation principles can be extended to correct for other trajectory types that are time-varying along the echo train and temporally asymmetric in TSE-based imaging.
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Affiliation(s)
- Zhixing Wang
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Rajiv Ramasawmy
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Xue Feng
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Adrienne E. Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - John P. Mugler
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Craig H. Meyer
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
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Sanchez F, Tyrrell PN, Cheung P, Heyn C, Graham S, Poon I, Ung Y, Louie A, Tsao M, Oikonomou A. Detection of solid and subsolid pulmonary nodules with lung MRI: performance of UTE, T1 gradient-echo, and single-shot T2 fast spin echo. Cancer Imaging 2023; 23:17. [PMID: 36793094 PMCID: PMC9933280 DOI: 10.1186/s40644-023-00531-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/04/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Although MRI is a radiation-free imaging modality, it has historically been limited in lung imaging due to inherent technical restrictions. The aim of this study is to explore the performance of lung MRI in detecting solid and subsolid pulmonary nodules using T1 gradient-echo (GRE) (VIBE, Volumetric interpolated breath-hold examination), ultrashort time echo (UTE) and T2 Fast Spin Echo (HASTE, Half fourier Single-shot Turbo spin-Echo). METHODS Patients underwent a lung MRI in a 3 T scanner as part of a prospective research project. A baseline Chest CT was obtained as part of their standard of care. Nodules were identified and measured on the baseline CT and categorized according to their density (solid and subsolid) and size (> 4 mm/ ≤ 4 mm). Nodules seen on the baseline CT were classified as present or absent on the different MRI sequences by two thoracic radiologists independently. Interobserver agreement was determined using the simple Kappa coefficient. Paired differences were compared using nonparametric Mann-Whitney U tests. The McNemar test was used to evaluate paired differences in nodule detection between MRI sequences. RESULTS Thirty-six patients were prospectively enrolled. One hundred forty-nine nodules (100 solid/49 subsolid) with mean size 10.8 mm (SD = 9.4) were included in the analysis. There was substantial interobserver agreement (k = 0.7, p = 0.05). Detection for all nodules, solid and subsolid nodules was respectively; UTE: 71.8%/71.0%/73.5%; VIBE: 61.6%/65%/55.1%; HASTE 72.4%/72.2%/72.7%. Detection rate was higher for nodules > 4 mm in all groups: UTE 90.2%/93.4%/85.4%, VIBE 78.4%/88.5%/63.4%, HASTE 89.4%/93.8%/83.8%. Detection of lesions ≤4 mm was low for all sequences. UTE and HASTE performed significantly better than VIBE for detection of all nodules and subsolid nodules (diff = 18.4 and 17.6%, p = < 0.01 and p = 0.03, respectively). There was no significant difference between UTE and HASTE. There were no significant differences amongst MRI sequences for solid nodules. CONCLUSIONS Lung MRI shows adequate performance for the detection of solid and subsolid pulmonary nodules larger than 4 mm and can serve as a promising radiation-free alternative to CT.
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Affiliation(s)
- Felipe Sanchez
- grid.17063.330000 0001 2157 2938Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - Pascal N. Tyrrell
- grid.17063.330000 0001 2157 2938Department of Medical Imaging, Department of Statistical Sciences, Institute of Medical Science, University of Toronto, 263 McCaul Street, Toronto, Ontario M5T 1WT Canada
| | - Patrick Cheung
- grid.17063.330000 0001 2157 2938Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - Chinthaka Heyn
- grid.17063.330000 0001 2157 2938Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - Simon Graham
- grid.17063.330000 0001 2157 2938Physical Sciences Platform of Sunnybrook Research Institute, Department of Medical Biophysics, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - Ian Poon
- grid.17063.330000 0001 2157 2938Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - Yee Ung
- grid.17063.330000 0001 2157 2938Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - Alexander Louie
- grid.17063.330000 0001 2157 2938Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - May Tsao
- grid.17063.330000 0001 2157 2938Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada
| | - Anastasia Oikonomou
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
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Kızıloğlu HA, Karaman A, Dilek O, Kasali K, Alper F. Evaluation of pulmonary nodules by magnetic resonance imaging sequences: which sequence will replace computed tomography? Rev Assoc Med Bras (1992) 2022; 68:1519-1523. [PMID: 36449768 PMCID: PMC9720765 DOI: 10.1590/1806-9282.20220215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study aimed to determine the role of magnetic resonance imaging in minimizing radiation exposure, especially in the follow-up of pulmonary nodules. METHODS Patients who applied to our hospital between April 2013 and August 2018 for various reasons and had lung-mediastinal dynamic magnetic resonance imaging and thoracic computed tomography were included in the study. A total of 194 patients were included in the study, involving 84 females and 110 males. Scanning of the nodules was done retrospectively. This study was conducted by two readers: a thoracic radiologist with 15 years of experience and a nonspecific radiologist with 4 years of experience. Evaluations were made using the double-blind method. RESULTS Of the 194 patients, 84 (43.3%) were female and 110 (56.7%) were male. For the first reader, 135 (69.5%) nodules were detected in postcontrast T1 vibe images, 130 (67%) in T2 fast spin echo, 128 (66%) in precontrast T1 vibe, and 98 (50.5%) in T2 turbo inversion recovery magnitude sequence. For the second reader, 133 (68%) nodules were detected in postcontrast T1 vibe images, 120 (61.9%) in T2 fast spin echo, 122 (62.9%) in precontrast T1 vibe, and 99 (51%) in T2 turbo inversion recovery magnitude sequence. Capability levels were examined in detecting nodules between the first and second readers, and the ratios were reached at 0.92 in T2 fast spin echo, 0.81 in postcontrast T1 vibe images, 0.93 in precontrast T1 vibe, and 0.96 in T2 turbo inversion recovery magnitude sequence. CONCLUSION In this study of detecting pulmonary nodules by magnetic resonance imaging, which we performed with two different readers, one of whom was an experienced thoracic radiologist, both readers found the highest detection rate in the postcontrast T1 vibe sequence.
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Feng H, Shi G, Liu H, Xu Q, Wang L, Zhang N. The Application and Value of 3T Magnetic Resonance Imaging in the Display of Pulmonary Nodules. Front Oncol 2022; 12:844514. [PMID: 35664742 PMCID: PMC9157594 DOI: 10.3389/fonc.2022.844514] [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: 01/14/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022] Open
Abstract
Objective The aim of this study was to evaluate the sensitivity and accuracy of multi-sequence 3T magnetic resonance imaging (MRI) in the detection of different types of pulmonary nodules. Methods A total of 68 patients with pulmonary nodules identified using computed tomography (CT) subsequently underwent MRI. Using CT images with a slice thickness of 1 mm as the gold standard, the sensitivity of three MRI sequences in detecting different types of pulmonary nodules was calculated, and the image quality was also evaluated. Nodule types included solid nodules, ground glass nodules (GGN), and part-solid nodules (PSN). Statistical analyses of data were conducted using the software SPSS 21.0. The intra-class correlation coefficient was calculated in order to compare the consistency of nodule size in both MRI and CT. Results CT detected 188 pulmonary nodules in 68 patients, including 87 solid nodules and 101 sub-solid nodules, the latter comprising 46 PSNs and 55 GGNs. The average nodule diameter was approximately 7.7 mm. The sensitivity of MRI in detecting nodules ≥ 6 mm in diameter and those of > 8 mm in diameter was 92% and 100%, respectively, and the sequence with the highest detection rate was T2-BLADE. In relation to solid nodules, the sequence with the highest detection rate was T1 Star-VIBE, while the T2-BLADE sequence demonstrated the highest detection rate of sub-solid nodules. The image quality of the T1 Star-VIBE sequence was better than that of both the T2-HASTE and the T2-BLADE sequences. The consistency of CT and MRI sequences for nodule size was high with a consistency coefficient of 0.94–0.98. Conclusion The detection rate of MRI for nodules with a diameter of > 8 mm was 100%. The T2-BLADE sequence had the highest detection sensitivity. The sequence with the best image quality was the T1 Star-VIBE.
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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
| | - Qian Xu
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lijia Wang
- 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
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Whole Body MRI in the Detection of Lymph Node Metastases in Patients with Testicular Germ Cell Cancer. Life (Basel) 2022; 12:life12020212. [PMID: 35207499 PMCID: PMC8875751 DOI: 10.3390/life12020212] [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: 12/30/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/16/2022] Open
Abstract
Whole-Body Magnetic Resonance Imaging (WB-MRI) is increasingly used for metastatic screening in oncology. This prospective single center study assesses the diagnostic value of WB-MRI including diffusion weighted imaging (DWI) and identifies the sufficient protocol for metastatic lymph node detection in patients with testicular germ cell cancer (TGCC). Forty-three patients underwent contrast enhanced thoraco-abdominopelvic CT (TAP-CT) and WB-MRI with DWI for metastatic lymph node screening. Two independent readers reviewed CTs and WB-MRIs. The diagnostic performance of different imaging protocols (CT, complete WB-MRI, T1W + DWI, T2W + DWI), the agreement between these protocols and the reference standard, the reproducibility of findings and the image quality (Signal and contrast to Noise Ratios, Likert scale) were studied. Reproducibility was very good regardless of both lesion locations (retroperitoneal vs distant lymph nodes, other lesions) and the reader. Diagnostic accuracy of MRI was ≥95% (regardless of the locations and imaging protocol); accuracy of CT was ≥93%. There was a strict overlap of 95% CIs associated with this accuracy between complete WB-MRI, T1W + DWI and T2W + DWI, regardless of the reader. Higher Likert score and SNR were observed for DWI, followed by T2W and T1W sequences. In conclusion, a fast WB-MRI protocol including T2W and DWI is a sufficient, accurate, non-irradiating alternative to TAP-CT for metastatic lymph node screening in TGCC.
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Ohno Y, Takenaka D, Yoshikawa T, Yui M, Koyama H, Yamamoto K, Hamabuchi N, Shigemura C, Watanabe A, Ueda T, Ikeda H, Hattori H, Murayama K, Toyama H. Efficacy of Ultrashort Echo Time Pulmonary MRI for Lung Nodule Detection and Lung-RADS Classification. Radiology 2021; 302:697-706. [PMID: 34846203 DOI: 10.1148/radiol.211254] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Pulmonary MRI with ultrashort echo time (UTE) has been compared with chest CT for nodule detection and classification. However, direct comparisons of these methods' capabilities for Lung CT Screening Reporting and Data System (Lung-RADS) evaluation remain lacking. Purpose To compare the capabilities of pulmonary MRI with UTE with those of standard- or low-dose thin-section CT for Lung-RADS classification. Materials and Methods In this prospective study, standard- and low-dose chest CT (270 mA and 60 mA, respectively) and MRI with UTE were used to examine consecutive participants enrolled between January 2017 and December 2020 who met American College of Radiology Appropriateness Criteria for lung cancer screening with low-dose CT. Probability of nodule presence was assessed for all methods with a five-point visual scoring system by two board-certified radiologists. All nodules were then evaluated in terms of their Lung-RADS classification using each method. To compare nodule detection capability of the three methods, consensus for performances was rated by using jackknife free-response receiver operating characteristic analysis, and sensitivity was compared by means of the McNemar test. In addition, weighted κ statistics were used to determine the agreement between Lung-RADS classification obtained with each method and the reference standard generated from standard-dose CT evaluated by two radiologists who were not included in the image analysis session. Results A total of 205 participants (mean age: 64 years ± 7 [standard deviation], 106 men) with 1073 nodules were enrolled. Figure of merit (FOM) (P < .001) had significant differences among three modalities (standard-dose CT: FOM = 0.91, low-dose CT: FOM = 0.89, pulmonary MRI with UTE: FOM = 0.94), with no evidence of false-positive findings in participants with all modalities (P > .05). Agreements for Lung-RADS classification between all modalities and the reference standard were almost perfect (standard-dose CT: κ = 0.82, P < .001; low-dose CT: κ = 0.82, P < .001; pulmonary MRI with UTE: κ = 0.82, P < .001). Conclusion In a lung cancer screening population, ultrashort echo time pulmonary MRI was comparable to standard- or low-dose CT for Lung CT Screening Reporting and Data System classification. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Wielpütz in this issue.
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Affiliation(s)
- Yoshiharu Ohno
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Daisuke Takenaka
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Takeshi Yoshikawa
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Masao Yui
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Hisanobu Koyama
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Kaori Yamamoto
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Nayu Hamabuchi
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Chika Shigemura
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Ayumi Watanabe
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Takahiro Ueda
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Hirotaka Ikeda
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Hidekazu Hattori
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Kazuhiro Murayama
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
| | - Hiroshi Toyama
- From the Department of Radiology (Y.O., N.H., C.S., A.W., T.U., H.I., H.H., H.T.) and Joint Research Laboratory of Advanced Biomedical Imaging (Y.O., K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., T.Y.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan (D.T., T.Y.); Canon Medical Systems, Otawara, Japan (M.Y., K.Y.); and Department of Radiology, Osaka Police Hospital, Osaka, Japan (H.K.)
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10
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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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11
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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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12
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Canan A, Batra K, Saboo SS, Landay M, Kandathil A. Radiological approach to cavitary lung lesions. Postgrad Med J 2020; 97:521-531. [PMID: 32934178 DOI: 10.1136/postgradmedj-2020-138694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/31/2020] [Indexed: 11/03/2022]
Abstract
Cavitary lesions in the lung are not an uncommon imaging encounter and carry a broad differential diagnosis that includes a wide range of pathological conditions from cancers, infections/inflammatory processes to traumatic and congenital lung abnormalities. In this review article, we describe a comprehensive approach for evaluation of cavitary lung lesions and discuss the differential diagnosis in the light of radiological findings.
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Affiliation(s)
| | - Kiran Batra
- Department of Radiology, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, 75390, USA
| | - Sachin S Saboo
- Department of Radiology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, 78229, USA
| | - Michael Landay
- Department of Radiology, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, 75390, USA
| | - Asha Kandathil
- Department of Radiology, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, 75390, USA
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13
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Fast thoracic MRI as an alternative to chest x-ray: A retrospective evaluation of 287 patients. Clin Imaging 2020; 60:244-248. [DOI: 10.1016/j.clinimag.2019.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 11/20/2022]
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15
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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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16
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Ohno Y, Koyama H, Yoshikawa T, Kishida Y, Seki S, Takenaka D, Yui M, Miyazaki M, Sugimura K. Standard-, Reduced-, and No-Dose Thin-Section Radiologic Examinations: Comparison of Capability for Nodule Detection and Nodule Type Assessment in Patients Suspected of Having Pulmonary Nodules. Radiology 2017; 284:562-573. [PMID: 28263700 DOI: 10.1148/radiol.2017161037] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose To compare the capability of pulmonary thin-section magnetic resonance (MR) imaging with ultrashort echo time (UTE) with that of standard- and reduced-dose thin-section computed tomography (CT) in nodule detection and evaluation of nodule type. Materials and Methods The institutional review board approved this study, and written informed consent was obtained from each patient. Standard- and reduced-dose chest CT (60 and 250 mA) and MR imaging with UTE were used to examine 52 patients; 29 were men (mean age, 66.4 years ± 7.3 [standard deviation]; age range, 48-79 years) and 23 were women (mean age, 64.8 years ± 10.1; age range, 42-83 years). Probability of nodule presence was assessed for all methods with a five-point visual scoring system. All nodules were then classified as missed, ground-glass, part-solid, or solid nodules. To compare nodule detection capability of the three methods, consensus for performances was rated by using jackknife free-response receiver operating characteristic analysis, and κ analysis was used to compare intermethod agreement for nodule type classification. Results There was no significant difference (F = 0.70, P = .59) in figure of merit between methods (standard-dose CT, 0.86; reduced-dose CT, 0.84; MR imaging with UTE, 0.86). There was no significant difference in sensitivity between methods (standard-dose CT vs reduced-dose CT, P = .50; standard-dose CT vs MR imaging with UTE, P = .50; reduced-dose CT vs MR imaging with UTE, P >.99). Intermethod agreement was excellent (standard-dose CT vs reduced-dose CT, κ = 0.98, P < .001; standard-dose CT vs MR imaging with UTE, κ = 0.98, P < .001; reduced-dose CT vs MR imaging with UTE, κ = 0.99, P < .001). Conclusion Pulmonary thin-section MR imaging with UTE was useful in nodule detection and evaluation of nodule type, and it is considered at least as efficacious as standard- or reduced-dose thin-section CT. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Yoshiharu Ohno
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Hisanobu Koyama
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Takeshi Yoshikawa
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Yuji Kishida
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Shinichiro Seki
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Daisuke Takenaka
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Masao Yui
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Mitsue Miyazaki
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Kazuro Sugimura
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
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Ulus S, Suleyman E, Ozcan UA, Karaarslan E. Whole-Body MRI Screening in Asymptomatic Subjects; Preliminary Experience and Long-Term Follow-Up Findings. Pol J Radiol 2016; 81:407-14. [PMID: 27635171 PMCID: PMC5008738 DOI: 10.12659/pjr.897570] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/25/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The aim of this study is to describe the technique and to evaluate the results of whole-body magnetic resonance imaging in an asymptomatic population. MATERIAL/METHODS Between March 2009 and December 2011, 118 consecutive subjects undergoing thorough medical check-up were prospectively included in the study. MRI was performed with a 205-cm moving table, parallel imaging and automatic image composing software. RESULTS In 83 subjects (70%), 103 benign lesions were detected. Two malignant (adrenal and renal carcinoma) lesions and one precancerous (pancreatic mucinous carcinoma) lesion were detected. The most common lesions were renal cysts, liver hemangiomas, liver cysts, thyroid nodules, and uterine leiomyomas. CONCLUSIONS WB-MRI is able to cover area from head to toes in one diagnostic work-up, and besides the anatomic regions evaluated by conventional radiological modalities, i.e. brain parenchyma, bones and extremities, can be evaluated in one examination.
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Affiliation(s)
- Sila Ulus
- Department of Radiology, Acıbadem University, School of Medicine, Istanbul, Turkey
| | - Erdogan Suleyman
- Department of Radiology, Acıbadem Maslak Hospital, Istanbul, Turkey
| | - Umit Aksoy Ozcan
- Department of Radiology, Acıbadem University, School of Medicine, Istanbul, Turkey
| | - Ercan Karaarslan
- Department of Radiology, Acıbadem University, School of Medicine, Istanbul, Turkey
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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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Rodrigues JCL, Lyen SM, Loughborough W, Amadu AM, Baritussio A, Dastidar AG, Manghat NE, Bucciarelli-Ducci C. Extra-cardiac findings in cardiovascular magnetic resonance: what the imaging cardiologist needs to know. J Cardiovasc Magn Reson 2016; 18:26. [PMID: 27156861 PMCID: PMC4860770 DOI: 10.1186/s12968-016-0246-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/21/2016] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) is an established non-invasive technique to comprehensively assess cardiovascular structure and function in a variety of acquired and inherited cardiac conditions. A significant amount of the neck, thorax and upper abdomen are imaged at the time of routine clinical CMR, particularly in the initial multi-slice axial and coronal images. The discovery of unsuspected disease at the time of imaging has ethical, financial and medico-legal implications. Extra-cardiac findings at the time of CMR are common, can be important and can change clinical management. Certain patient groups undergoing CMR are at particular risk of important extra-cardiac findings as several of the cardiovascular risk factors for atherosclerosis are also risk factors for malignancy. Furthermore, the presence of certain extra-cardiac findings may contribute to the interpretation of the primary cardiac pathology as some cardiac conditions have multi-systemic extra-cardiac involvement. The aim of this review is to give an overview of the type of extra-cardiac findings that may become apparent on CMR, subdivided by anatomical location. We focus on normal variant anatomy that may mimic disease, common incidental extra-cardiac findings and important imaging signs that help distinguish sinister pathology from benign disease. We also aim to provide a framework to the approach and potential further diagnostic work-up of incidental extra-cardiac findings discovered at the time of CMR. However, it is beyond the scope of this review to discuss and determine the clinical significance of extracardiac findings at CMR.
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Affiliation(s)
- Jonathan C L Rodrigues
- Cardiovascular Magnetic Resonance Unit, NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, UK
- Department of Clinical Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK
- School of Physiology, Pharmacology and Neurosciences, Faculty of Biomedical Sciences, University of Bristol, Medical Sciences Building, University Walk, Bristol, BS8 1TD, UK
| | - Stephen M Lyen
- Department of Clinical Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - William Loughborough
- Department of Clinical Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Antonio Matteo Amadu
- Cardiovascular Magnetic Resonance Unit, NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, UK
- Department of Surgical, Microsurgical and Medical Sciences, Institute of Radiological Sciences, University of Sassari, Sassari, Italy
| | - Anna Baritussio
- Cardiovascular Magnetic Resonance Unit, NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, UK
- Department of Cardiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Amardeep Ghosh Dastidar
- Cardiovascular Magnetic Resonance Unit, NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, UK
- Department of Cardiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Nathan E Manghat
- Department of Clinical Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Chiara Bucciarelli-Ducci
- Cardiovascular Magnetic Resonance Unit, NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, UK.
- Department of Cardiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK.
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Dewes P, Frellesen C, Al-Butmeh F, Albrecht MH, Scholtz JE, Metzger SC, Lehnert T, Vogl TJ, Wichmann JL. Comparative evaluation of non-contrast CAIPIRINHA-VIBE 3T-MRI and multidetector CT for detection of pulmonary nodules: In vivo evaluation of diagnostic accuracy and image quality. Eur J Radiol 2016; 85:193-198. [DOI: 10.1016/j.ejrad.2015.11.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/09/2015] [Accepted: 11/12/2015] [Indexed: 02/07/2023]
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Mosavi F, Laurell A, Ahlström H. Whole body MRI, including diffusion-weighted imaging in follow-up of patients with testicular cancer. Acta Oncol 2015; 54:1763-9. [PMID: 25975210 DOI: 10.3109/0284186x.2015.1043027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Whole body (WB) magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) has become increasingly utilized in cancer imaging, yet the clinical utility of these techniques in follow-up of testicular cancer patients has not been evaluated. The purpose of this study was to evaluate the feasibility of WB MRI with continuous table movement (CTM) technique, including multistep DWI in follow-up of patients with testicular cancer. PATIENTS AND METHODS WB MRI including DWI was performed in follow-up of 71 consecutive patients (median age, 37 years; range 19-84) with histologically confirmed testicular cancer. WB MRI protocol included axial T1-Dixon and T2-BLADE sequences using CTM technique. Furthermore, multi-step DWI was performed using b-value 50 and 1000 s/mm(2). One criterion for feasibility was patient tolerance and satisfactory image quality. Another criterion was the accuracy in detection of any pathological mass, compared to standard of reference. Signal intensity in DWI was used for evaluation of residual mass activity. Clinical, laboratory and imaging follow-up were applied as standard of reference for the evaluation of WB MRI. RESULTS WB MRI was tolerated in nearly all patients (69/71 patients, 97%) and the image quality was satisfactory. Metal artifacts deteriorated the image quality in six patients, but it did not influence the overall results. No case of clinical relapse was observed during the follow-up time. There was a good agreement between conventional WB MRI and standard of reference in all patients. Three patients showed residual masses and DWI signal was not restricted in these patients. Furthermore, DWI showed abnormally high signal intensity in a normal-sized retroperitoneal lymph node indicating metastasis. The subsequent (18)F-FDG PET/CT could verify the finding. CONCLUSION WB MRI with CTM technique including multi-step DWI is feasible in follow-up of patients with testicular cancer. DWI may contribute to important added-value data to conventional MRI sequences regarding the activity of residual masses.
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Affiliation(s)
- Firas Mosavi
- a Section of Radiology, Department of Radiology , Oncology and Radiation Science, Uppsala University Hospital , Uppsala , Sweden
| | - Anna Laurell
- b Section of Oncology, Department of Radiology , Oncology and Radiation Science, Uppsala University Hospital , Uppsala , Sweden
| | - Håkan Ahlström
- a Section of Radiology, Department of Radiology , Oncology and Radiation Science, Uppsala University Hospital , Uppsala , Sweden
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Callister MEJ, Baldwin DR, Akram AR, Barnard S, Cane P, Draffan J, Franks K, Gleeson F, Graham R, Malhotra P, Prokop M, Rodger K, Subesinghe M, Waller D, Woolhouse I. British Thoracic Society guidelines for the investigation and management of pulmonary nodules. Thorax 2015; 70 Suppl 2:ii1-ii54. [PMID: 26082159 DOI: 10.1136/thoraxjnl-2015-207168] [Citation(s) in RCA: 570] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M E J Callister
- Department of Respiratory Medicine, Leeds Teaching Hospitals, Leeds, UK
| | - D R Baldwin
- Nottingham University Hospitals, Nottingham, UK
| | - A R Akram
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | - S Barnard
- Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle, UK
| | - P Cane
- Department of Histopathology, St Thomas' Hospital, London, UK
| | - J Draffan
- University Hospital of North Tees, Stockton on Tees, UK
| | - K Franks
- Clinical Oncology, St James's Institute of Oncology, Leeds, UK
| | - F Gleeson
- Department of Radiology, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - P Malhotra
- St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - M Prokop
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - K Rodger
- Respiratory Medicine, St James's University Hospital, Leeds, UK
| | - M Subesinghe
- Department of Radiology, Churchill Hospital, Oxford, UK
| | - D Waller
- Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK
| | - I Woolhouse
- Department of Respiratory Medicine, University Hospitals of Birmingham, Birmingham, UK
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Sommer G, Koenigkam-Santos M, Biederer J, Puderbach M. [Role of MRI for detection and characterization of pulmonary nodules]. Radiologe 2015; 54:470-7. [PMID: 24756231 DOI: 10.1007/s00117-013-2604-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Due to physical and technical limitations, magnetic resonance imaging (MRI) has hitherto played only a minor role in image-based diagnostics of the lungs. However, as a consequence of important methodological developments during recent years, MRI has developed into a technically mature and clinically well-proven method for specific pulmonary questions. OBJECTIVES AND METHODS The purpose of this article is to provide an overview on the currently available sequences and techniques for assessment of pulmonary nodules and analyzes the clinical significance according to the current literature. The main focus is on the detection of lung metastases, the detection of primary pulmonary malignancies in high-risk individuals and the differentiation between pulmonary nodules of benign and malignant character. RESULTS AND CONCLUSION The MRI technique has a sensitivity of approximately 80 % for detection of malignant pulmonary nodules compared to the reference standard low-dose computed tomography (CT) and is thus somewhat inferior to CT. Advantages of MRI on the other hand are a higher specificity in differentiating malignant and benign pulmonary nodules and the absence of ionizing radiation exposure. A systematic use of MRI as a primary tool for detection and characterization of pulmonary nodules is currently not recommended due to insufficient data. The diagnostic potential of MRI for early detection and staging of malignant pulmonary diseases, however, seems promising. Therefore, further evaluation of MRI as a secondary imaging modality in clinical trials is highly warranted.
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Affiliation(s)
- G Sommer
- Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz,
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Fraioli F, Screaton NJ, Janes SM, Win T, Menezes L, Kayani I, Syed R, Zaccagna F, O'Meara C, Barnes A, Bomanji JB, Punwani S, Groves AM. Non-small-cell lung cancer resectability: diagnostic value of PET/MR. Eur J Nucl Med Mol Imaging 2015; 42:49-55. [PMID: 25120040 PMCID: PMC4244545 DOI: 10.1007/s00259-014-2873-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/20/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE To assess the diagnostic performance of PET/MR in patients with non-small-cell lung cancer. METHODS Fifty consecutive consenting patients who underwent routine (18)F-FDG PET/CT for potentially radically treatable lung cancer following a staging CT scan were recruited for PET/MR imaging on the same day. Two experienced readers, unaware of the results with the other modalities, interpreted the PET/MR images independently. Discordances were resolved in consensus. PET/MR TNM staging was compared to surgical staging from thoracotomy as the reference standard in 33 patients. In the remaining 17 nonsurgical patients, TNM was determined based on histology from biopsy, imaging results (CT and PET/CT) and follow-up. ROC curve analysis was used to assess accuracy, sensitivity and specificity of the PET/MR in assessing the surgical resectability of primary tumour. The kappa statistic was used to assess interobserver agreement in the PET/MR TNM staging. Two different readers, without knowledge of the PET/MR findings, subsequently separately reviewed the PET/CT images for TNM staging. The generalized kappa statistic was used to determine intermodality agreement between PET/CT and PET/MR for TNM staging. RESULTS ROC curve analysis showed that PET/MR had a specificity of 92.3 % and a sensitivity of 97.3 % in the determination of resectability with an AUC of 0.95. Interobserver agreement in PET/MR reading ranged from substantial to perfect between the two readers (Cohen's kappa 0.646 - 1) for T stage, N stage and M stage. Intermodality agreement between PET/CT and PET/MR ranged from substantial to almost perfect for T stage, N stage and M stage (Cohen's kappa 0.627 - 0.823). CONCLUSION In lung cancer patients PET/MR appears to be a robust technique for preoperative staging.
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Affiliation(s)
- Francesco Fraioli
- Department of Nuclear Medicine and Radiology, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK,
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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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Sayyouh M, Vummidi DR, Kazerooni EA. Evaluation and management of pulmonary nodules: state-of-the-art and future perspectives. ACTA ACUST UNITED AC 2014; 7:629-44. [PMID: 24175679 DOI: 10.1517/17530059.2013.858117] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The imaging evaluation of pulmonary nodules, often incidentally detected on imaging examinations performed for other clinical reasons, is a frequently encountered clinical circumstance. With advances in imaging modalities, both the detection and characterization of pulmonary nodules continue to evolve and improve. AREAS COVERED This article will review the imaging modalities used to detect and diagnose benign and malignant pulmonary nodules, with a focus on computed tomography (CT), which continues to be the mainstay for evaluation. The authors discuss recent advances in the lung nodule management, and an algorithm for the management of indeterminate pulmonary nodules. EXPERT OPINION There are set of criteria that define a benign nodule, the most important of which are the lack of temporal change for 2 years or more, and certain benign imaging criteria, including specific patterns of calcification or the presence of fat. Although some indeterminate pulmonary nodules are immediately actionable, generally those approaching 1 cm or larger in diameter, at which size the diagnostic accuracy of tools such as positron emission tomography (PET)/CT, single photon emission CT (SPECT) and biopsy techniques are sufficient to warrant their use. The majority of indeterminate pulmonary nodules are under 1 cm, for which serial CT examinations through at least 2 years for solid nodules and 3 years for ground-glass nodules, are used to demonstrate either benign biologic behavior or otherwise. The management of incidental pulmonary nodules involves a multidisciplinary approach in which radiology plays a pivotal role. Newer imaging and postprocessing techniques have made this a more accurate technique eliminating ambiguity and unnecessary follow-up.
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Affiliation(s)
- Mohamed Sayyouh
- University of Michigan Health System, Division of Cardiothoracic Radiology, Department of Radiology , Ann Arbor, MI , USA
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Montella S, Mollica C, Finocchi A, Pession A, Pietrogrande MC, Trizzino A, Ranucci G, Maglione M, Giardino G, Salvatore M, Santamaria F, Pignata C. Non invasive assessment of lung disease in ataxia telangiectasia by high-field magnetic resonance imaging. J Clin Immunol 2013; 33:1185-91. [PMID: 23975689 DOI: 10.1007/s10875-013-9933-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/08/2013] [Indexed: 12/18/2022]
Abstract
PURPOSE A sensitive imaging technique that assesses ataxia telangiectasia (AT) lung disease without ionizing radiation is highly desirable. We designed a study to evaluate lung changes using magnetic resonance imaging (MRI), and to investigate the relationships among severity and extent of pulmonary abnormalities and clinical, microbiological and functional data in children and young adults with AT. METHODS Fifteen AT patients (age, 11.3 years; range, 6-31) underwent 3.0-T MRI, spirometry, and deep throat or sputum culture. Images were scored using a modified Helbich score. RESULTS Although only 8 patients (53 %) had recurrent/chronic respiratory symptoms, MRI identified lung abnormalities in all. Bronchiectasis, peribronchial thickening, mucous plugging, and collapse/consolidation were present in 60 %, 87 %, 67 %, and 13 % of cases, respectively, with no difference between subjects with or without respiratory symptoms. No difference in changes of specific scores was found between the two groups, but the total MRI score was higher in patients with respiratory symptoms (6.5 versus 5, respectively; p = 0.02). Total or specific MRI scores were not associated with patients' age. Of all scores, only mucous plugging subscore appeared significantly related to FEV1 (r = 0.7, p = 0.04) and FEF25-75% (r = 0.9, p = 0.001). MRI scores from patients with positive (n = 5) or negative (n = 10) sputum culture were not significantly different. CONCLUSIONS MRI is valuable in the assessment of extent and severity of pulmonary changes in children and adults with AT. It represents an helpful tool for the longitudinal evaluation of patients and may be also used as an outcome surrogate to track the effects of medications.
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Affiliation(s)
- Silvia Montella
- Department of Translational Medical Sciences, "Federico II" University, Via Pansini 5, 80131, Naples, Italy
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Alper F, Kurt ATP, Aydin Y, Ozgokce M, Akgun M. The role of dynamic magnetic resonance imaging in the evaluation of pulmonary nodules and masses. Med Princ Pract 2013; 22:80-6. [PMID: 22797711 PMCID: PMC5586702 DOI: 10.1159/000339475] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 05/09/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of our study was to determine whether or not dynamic magnetic resonance imaging (MRI) with kinetic and morphological parameters can reveal significant differences between malignant and benign pulmonary lesions, and thus to evaluate the use of dynamic MRI in the management of pulmonary nodules. PATIENTS AND METHODS Thirty-one patients (4 women and 27 men) underwent 1.5 T MRI, where 10 consecutive dynamic series were performed every 30 s by using 3D fast low-angle shot sequences. The percentage increase in the signal intensity of the lesions was determined for each time point. Time-enhancement curves of the lesions were drawn and classified into four types: A, B, C and D. Early peak (EP) and maximum peak (MP) values of the curves were calculated and compared with the diagnoses of the patients. The usefulness of these parameters was tested statistically. In addition to the comparison of the parameters between the groups, receiver-operating characteristic analysis was used to assess sensitivity, specificity, and both positive and negative predictive values of EP and MP parameters. RESULTS Of the 31 pulmonary lesions, 16 (52%) were malignant. These showed a stronger enhancement with higher median values of EP and MP (77.08 and 123.15, respectively) than those corresponding to the benign lesions (14.45 and 32.53, respectively). There were significant differences between the benign and malignant lesions (p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive value were 75, 93, 92 and 78% for EP and 93, 86, 88 and 93% for MP, respectively. CONCLUSION A combination of kinetic and morphological evaluation in dynamic MRI provided accurate differentiation between benign and malignant pulmonary lesions. It was a useful and noninvasive method of evaluating pulmonary nodules.
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Affiliation(s)
| | | | - Yener Aydin
- Department of Thoracic Surgery, Erzurum, Turkey
- *Dr. Yener Aydin, Department of Thoracic Surgery, Faculty of Medicine, Ataturk University, TR-252400 Erzurum (Turkey), Tel. +90 442 316 6333/2181, E-Mail
| | | | - Metin Akgun
- Department of Chest Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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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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Veit-Haibach P, Kuhn FP, Wiesinger F, Delso G, von Schulthess G. PET-MR imaging using a tri-modality PET/CT-MR system with a dedicated shuttle in clinical routine. MAGMA (NEW YORK, N.Y.) 2012. [PMID: 23053712 DOI: 10.1007/s10334‐012‐0344‐5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Tri-modality PET/CT-MRI includes the transfer of the patient on a dedicated shuttle from one system into the other. Advantages of this system include a true CT-based attenuation correction, reliable PET-quantification and higher flexibility in patient throughput on both systems. Comparative studies of PET/MRI versus PET/CT are readily accomplished without repeated PET with a different PET scanner at a different time point. Additionally, there is a higher imaging flexibility based on the availability of three imaging modalities, which can be combined for the characterization of the disease. The downside is a somewhat higher radiation dose of up to 3 mSv with a low dose CT based on the CT-component, longer acquisition times and potential misalignment between the imaging components. Overall, the tri-modality PET/CT-MR system offers comparative studies using the three different imaging modalities in the same patient virtually at the same time, and may help to develop reliable attenuation algorithms at the same time.
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Affiliation(s)
- Patrick Veit-Haibach
- Department of Medical Imaging, University Hospital, Rämistrasse 100, 8091 Zurich, Switzerland.
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Veit-Haibach P, Kuhn FP, Wiesinger F, Delso G, von Schulthess G. PET–MR imaging using a tri-modality PET/CT–MR system with a dedicated shuttle in clinical routine. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2012; 26:25-35. [DOI: 10.1007/s10334-012-0344-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 09/05/2012] [Accepted: 09/05/2012] [Indexed: 12/14/2022]
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Simulation of a MR–PET protocol for staging of head-and-neck cancer including Dixon MR for attenuation correction. Eur J Radiol 2012; 81:2658-65. [DOI: 10.1016/j.ejrad.2011.10.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 10/12/2011] [Accepted: 10/14/2011] [Indexed: 11/20/2022]
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Maglione M, Montella S, Santamaria F. Chest CTs in primary ciliary dyskinesia: not too few, but not too many! Pediatr Pulmonol 2012; 47:733-5. [PMID: 22570095 DOI: 10.1002/ppul.22589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 03/22/2012] [Indexed: 12/20/2022]
Affiliation(s)
- Marco Maglione
- Department of Pediatrics, Federico II University, Naples, Italy
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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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Santos MK, Elias J, Mauad FM, Muglia VF, Trad CS. Magnetic resonance imaging of the chest: current and new applications, with an emphasis on pulmonology. J Bras Pneumol 2011; 37:242-58. [PMID: 21537662 DOI: 10.1590/s1806-37132011000200016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 09/03/2010] [Indexed: 11/22/2022] Open
Abstract
The objective of the present review study was to present the principal applications of magnetic resonance imaging (MRI) of the chest, including the description of new techniques. Over the past decade, this method has evolved considerably because of the development of new equipment, including the simultaneous interconnection of phased-array multiple radiofrequency receiver coils and remote control of the table movement, in addition to faster techniques of image acquisition, such as parallel imaging and partial Fourier acquisitions, as well as the introduction of new contrast agents. All of these advances have allowed MRI to gain ground in the study of various pathologies of the chest, including lung diseases. Currently, MRI is considered the modality of choice for the evaluation of lesions in the mediastinum and in the chest wall, as well as of superior sulcus tumors. However, it can also facilitate the diagnosis of lung, pleural, and cardiac diseases, as well as of those related to the pulmonary vasculature. Pulmonary MRI angiography can be used in order to evaluate various pulmonary vascular diseases, and it has played an ever greater role in the study of thromboembolism. Because cardiac MRI allows morphological and functional assessment in the same test, it has also become part of the clinical routine in the evaluation of various cardiac diseases. Finally, the role of MRI has been extended to the identification and characterization of pulmonary nodules, the evaluation of airway diseases, and the characterization of pleural effusion.
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Affiliation(s)
- Marcel Koenigkam Santos
- Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
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MONTELLA SILVIA, MAGLIONE MARCO, BRUZZESE DARIO, MOLLICA CARMINE, PIGNATA CLAUDIO, ALOJ GIUSEPPINA, MANNA ANGELO, ESPOSITO ANTONIETTA, MIRRA VIRGINIA, SANTAMARIA FRANCESCA. Magnetic resonance imaging is an accurate and reliable method to evaluate non-cystic fibrosis paediatric lung disease. Respirology 2011; 17:87-91. [DOI: 10.1111/j.1440-1843.2011.02067.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Regier M, Schwarz D, Henes FO, Groth M, Kooijman H, Begemann PG, Adam G. Diffusion-weighted MR-imaging for the detection of pulmonary nodules at 1.5 Tesla: intraindividual comparison with multidetector computed tomography. J Med Imaging Radiat Oncol 2011; 55:266-74. [PMID: 21696559 DOI: 10.1111/j.1754-9485.2011.02263.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION To investigate the feasibility of diffusion-weighted imaging (DWI) MRI for detecting pulmonary nodules at 1.5 Tesla in comparison with standard multidetector computed tomography (MDCT). METHODS Twenty patients with disseminated cancer disease in which MDCT had assured the presence of at least one pulmonary nodule were examined using a respiratory-gated DWI MR-sequence. Grey scale inverted source images and coronal maximum intensity projection (MIP) images were consensually analysed by two experienced radiologists. Size and location of any nodule detected were assessed. Additionally, the readers evaluated each hemithorax for the presence of at least one nodule and applied a four-point conspicuity scale (1-hemithorax definitely affected; 4-hemithorax definitely not affected). MDCT data served as reference. RESULTS At MDCT, a total of 71 pulmonary noduIes was found (size 3-5mm, n=16; 6-9mm, n=22; ≥10mm, n=33). For the DWI MR-sequence, a sensitivity of 86.4% was calculated for nodules ranging 6-9mm and 97% for nodules ≥10mm. In contrast, only 43.8% of lesions ≤5mm was detected. The separate analysis of each hemithorax for the presence of at least one pulmonary nodule revealed a specificity rate, PPV and NPV of DWI-MR of 92.3%, 96% and 80%, respectively. CONCLUSIONS The presented study is the first to confirm the diagnostic potential of DWI-MR in the detection of solid lung nodules. This technique allows for the detection of nodules ≥6mm with reasonably high sensitivity rates (>86%). The observation of false positive findings decreases the accuracy of this approach compared with MDCT.
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Affiliation(s)
- Marc Regier
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf Philips Medical Systems, Hamburg, Germany.
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Hausmann D, Jochum S, Utikal J, Hoffmann RC, Zechmann C, Neff KW, Goerdt S, Schoenberg SO, Dinter DJ. Comparison of the diagnostic accuracy of whole-body MRI and whole-body CT in stage III/IV malignant melanoma. J Dtsch Dermatol Ges 2011; 9:212-22. [PMID: 21352483 DOI: 10.1111/j.1610-0387.2011.07614.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Malignant melanoma (MM) is dramatically increasing in light-skinned populations worldwide. Staging and regular follow-up examinations are essential. The purpose of this study was to compare the diagnostic accuracy of whole-body MRI with the standard diagnostic algorithm (whole-body CT and brain MRI) in patients with stage III/IV MM. PATIENTS AND METHODS A group of 50 consecutively admitted patients with stage III/IV MM were included in the study. Whole-body CT and brain MRI scans were performed. Additionally, all patients underwent a whole-body MRI (1.5 Tesla Magnetom Avanto, Siemens Healthcare Sector, Erlangen). The findings were compared on a lesion-by-lesion basis as part of clinical routine follow-up. RESULTS 33 patients received a follow-up CT and were evaluated. Overall, 824 lesions were detected. The sensitivity of whole-body MRI was observer-dependent. MRI was slightly less sensitive than CT according to the findings of the two most experienced observers (73.4 % vs. 78.2 %, p = 0.0744). CT was significantly more sensitive in the detection of small (1-5 mm) pulmonary nodules (2.9 % vs. 66.9 %, p < 0.0001). Yet overall, MRI was significantly more specific than CT (83.4 % vs. 50.4 %, p < 0.0001). CONCLUSIONS Whole-body MRI in compliance with standard requirements for the observers (high level of experience) should be considered as an appropriate alternative to CT without ionizing radiation, particularly for young patients with advanced MM.
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Affiliation(s)
- Daniel Hausmann
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, University of Heidelberg, Germany.
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Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions. Eur J Nucl Med Mol Imaging 2011; 38:1691-701. [PMID: 21688050 DOI: 10.1007/s00259-011-1842-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 05/02/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE In this study, the potential contribution of Dixon-based MR imaging with a rapid low-resolution breath-hold sequence, which is a technique used for MR-based attenuation correction (AC) for MR/positron emission tomography (PET), was evaluated for anatomical correlation of PET-positive lesions on a 3T clinical scanner compared to low-dose CT. This technique is also used in a recently installed fully integrated whole-body MR/PET system. METHODS Thirty-five patients routinely scheduled for oncological staging underwent (18)F-fluorodeoxyglucose (FDG) PET/CT and a 2-point Dixon 3-D volumetric interpolated breath-hold examination (VIBE) T1-weighted MR sequence on the same day. Two PET data sets reconstructed using attenuation maps from low-dose CT (PET(AC_CT)) or simulated MR-based segmentation (PET(AC_MR)) were evaluated for focal PET-positive lesions. The certainty for the correlation with anatomical structures was judged in the low-dose CT and Dixon-based MRI on a 4-point scale (0-3). In addition, the standardized uptake values (SUVs) for PET(AC_CT) and PET(AC_MR) were compared. RESULTS Statistically, no significant difference could be found concerning anatomical localization for all 81 PET-positive lesions in low-dose CT compared to Dixon-based MR (mean 2.51 ± 0.85 and 2.37 ± 0.87, respectively; p = 0.1909). CT tended to be superior for small lymph nodes, bone metastases and pulmonary nodules, while Dixon-based MR proved advantageous for soft tissue pathologies like head/neck tumours and liver metastases. For the PET(AC_CT)- and PET(AC_MR)-based SUVs (mean 6.36 ± 4.47 and 6.31 ± 4.52, respectively) a nearly complete concordance with a highly significant correlation was found (r = 0.9975, p < 0.0001). CONCLUSION Dixon-based MR imaging for MR AC allows for anatomical allocation of PET-positive lesions similar to low-dose CT in conventional PET/CT. Thus, this approach appears to be useful for future MR/PET for body regions not fully covered by diagnostic MRI due to potential time constraints.
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Ng SH, Chan SC, Yen TC, Liao CT, Lin CY, Tung-Chieh Chang J, Ko SF, Wang HM, Chang KP, Fan KH. PET/CT and 3-T whole-body MRI in the detection of malignancy in treated oropharyngeal and hypopharyngeal carcinoma. Eur J Nucl Med Mol Imaging 2011; 38:996-1008. [DOI: 10.1007/s00259-011-1740-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 01/04/2011] [Indexed: 11/30/2022]
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Abstract
This presentation discusses the optimum magnetic resonance imaging (MRI) sequence for lung cancer assessment in a clinical setting, and the sensitivity and specificity of MRI (alone and in combination with diffusion-weighted imaging (DWI)-MR) compared with those of computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (PET) for lung cancer staging. The role of perfusion studies (by CT or MRI), of DWI-MRI, blood oxygenation level dependent sequences and PET in defining the aggressiveness of lung tumours and in evaluating the response to radiochemotherapy is also discussed.
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Affiliation(s)
- M Bellomi
- European Institute of Oncology, Via Ripamonti 435, Milan, Italy
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Horn M, Oechsner M, Gardarsdottir M, Köstler H, Müller MF. Dynamic contrast-enhanced MR imaging for differentiation of rounded atelectasis from neoplasm. J Magn Reson Imaging 2010; 31:1364-70. [DOI: 10.1002/jmri.22176] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Ng SH, Chan SC, Yen TC, Liao CT, Chang JTC, Ko SF, Wang HM, Lin CY, Chang KP, Lin YC. Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT. Eur Radiol 2010; 20:2229-40. [DOI: 10.1007/s00330-010-1784-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 02/07/2010] [Accepted: 03/13/2010] [Indexed: 11/24/2022]
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Morin S, Cobbold J, Lim A, Eliahoo J, Thomas E, Mehta S, Durighel G, Fitzpatrick J, Bell J, Taylor-Robinson S. Incidental findings in healthy control research subjects using whole-body MRI. Eur J Radiol 2009; 72:529-33. [DOI: 10.1016/j.ejrad.2008.08.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 07/14/2008] [Accepted: 08/12/2008] [Indexed: 12/21/2022]
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Henzler T, Dietrich O, Krissak R, Wichmann T, Lanz T, Reiser MF, Schoenberg SO, Fink C. Half-Fourier-acquisition single-shot turbo spin-echo (HASTE) MRI of the lung at 3 Tesla using parallel imaging with 32-receiver channel technology. J Magn Reson Imaging 2009; 30:541-6. [PMID: 19711408 DOI: 10.1002/jmri.21882] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To assess the feasibility of half-Fourier-acquisition single-shot turbo spin-echo (HASTE) of the lung at 3 Tesla (T) using parallel imaging with a prototype of a 32-channel torso array coil, and to determine the optimum acceleration factor for the delineation of intrapulmonary anatomy. MATERIALS AND METHODS Nine volunteers were examined on a 32-channel 3T MRI system using a prototype 32-channel-torso-array-coil. HASTE-MRI of the lung was acquired at both, end-inspiratory and end-expiratory breathhold with parallel imaging (Generalized autocalibrating partially parallel acquisitions = GRAPPA) using acceleration factors ranging between R = 1 (TE = 42 ms) and R = 6 (TE = 16 ms). The image quality of intrapulmonary anatomy and subjectively perceived noise level was analyzed by two radiologists in consensus. In addition quantitative measurements of the signal-to-noise ratio (SNR) of HASTE with different acceleration factors were assessed in phantom measurements. RESULTS Using an acceleration factor of R = 4 image blurring was substantially reduced compared with lower acceleration factors resulting in sharp delineation of intrapulmonary structures in expiratory scans. For inspiratory scans an acceleration factor of 2 provided the best image quality. Expiratory scans had a higher subjectively perceived SNR than inspiratory scans. CONCLUSION Using optimized multi-element coil geometry HASTE-MRI of the lung is feasible at 3T with acceleration factors up to 4. Compared with nonaccelerated acquisitions, shorter echo times and reduced image blurring are achieved. Expiratory scanning may be favorable to compensate for susceptibility associated signal loss at 3T.
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Affiliation(s)
- Thomas Henzler
- Department of Clinical Radiology and Nuclear Medicine, University of Heidelberg, Germany.
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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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Assessment of Chest High-Field Magnetic Resonance Imaging in Children and Young Adults With Noncystic Fibrosis Chronic Lung Disease. Invest Radiol 2009; 44:532-8. [DOI: 10.1097/rli.0b013e3181b4c1ba] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schmidt GP, Baur-Melnyk A, Haug A, Utzschneider S, Becker CR, Tiling R, Reiser MF, Hermann KA. Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer. Eur Radiol 2009; 19:1366-78. [PMID: 19190917 DOI: 10.1007/s00330-008-1289-y] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Accepted: 12/09/2008] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to assess the diagnostic accuracy of whole-body MRI (WB-MRI) at 1.5 T or 3 T compared with FDG-PET-CT in the follow-up of patients suffering from colorectal cancer. In a retrospective study, 24 patients with a history of colorectal cancer and suspected tumour recurrence underwent FDG-PET-CT and WB-MRI with the use of parallel imaging (PAT) for follow-up. High resolution coronal T1w-TSE and STIR sequences at four body levels, HASTE imaging of the lungs, contrast-enhanced T1w- and T2w-TSE sequences of the liver, brain, abdomen and pelvis were performed, using WB-MRI at either 1.5 T (n = 14) or 3 T (n = 10). Presence of local recurrent tumour, lymph node involvement and distant metastatic disease was confirmed using radiological follow-up within at least 5 months as a standard of reference. Seventy seven malignant foci in 17 of 24 patients (71%) were detected with both WB-MRI and PET-CT. Both investigations concordantly revealed two local recurrent tumours. PET-CT detected significantly more lymph node metastases (sensitivity 93%, n = 27/29) than WB-MRI (sensitivity 63%, n = 18/29). PET-CT and WB-MRI achieved a similar sensitivity for the detection of organ metastases with 80% and 78%, respectively (37/46 and 36/46). WB-MRI detected brain metastases in one patient. One false-positive local tumour recurrence was indicated by PET-CT. Overall diagnostic accuracy for PET-CT was 91% (sensitivity 86%, specificity 96%) and 83% for WB-MRI (sensitivity 72%, specificity 93%), respectively. Examination time for WB-MRI at 1.5 T and 3 T was 52 min and 43 min, respectively; examination time for PET-CT was 103 min. Initial results suggest that differences in accuracy for local and distant metastases detection using FDG-PET-CT and WB-MRI for integrated screening of tumour recurrence in colorectal cancer depend on the location of the malignant focus. Our results show that nodal disease is better detected using PET-CT, whereas organ disease is depicted equally well by both investigations.
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Affiliation(s)
- G P Schmidt
- Department of Clinical Radiology, University Hospitals Grosshadern, Ludwig Maximilian University Munich, Marchioninistr. 15, 81377, Munich, Germany.
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