Comparison of Ultrashort TE Lung MRI and HRCT Lungs for Detection of Pulmonary Nodules in Oncology Patients

Abstract

Purpose The purpose of this study is to evaluate the detection rate of pulmonary nodules in ultrashort echo time (UTE) lung magnetic resonance imaging (MRI) and to compare it with computed tomography (CT) in oncology patients.

Materials and Methods All individuals undergoing radiotherapy/chemotherapy/regular follow-up or visiting the oncology department and referred to radiology department for nodule detection, during the period of 1 year, were subjected to UTE lung MRI using the sequence Flash 3d_spiralvibe coronal 1.25 mm iso and high-resolution CT lungs and the images were analyzed.

Results Among the total number of nodules detected in both lungs of all patients, nodules detected by CT were 241, and nodules detected by MRI were 212. The nodule detection rate by MRI was 87.96%. The detection rate of nodules for size equal to or more than 5 mm was nearly 100%. For nodules less than 5 mm, and equal to or more than 4 mm, MRI showed a comparable detection rate of 75%, while for nodules less than 4 mm, the detection rate was only 25%.

Conclusion Our study results indicate that lung MRI had a near-complete detection rate for nodules equal to or more than 5 mm in size. Hence, in oncology patients who are undergoing regular follow-up of the lung nodules, lung MRI using UTE can replace low-dose CT, which in turn reduces the radiation dose to the patient.

Keywords

pulmonary nodules - ultrashort TE lung MRI - oncology - HRCT lungs

• References

• 1 Aberle DR, Adams AM, Berg CD. et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011; 365 (05) 395-409
• 2 Cha MJ, Park HJ, Paek MY. et al. Free-breathing ultrashort echo time lung magnetic resonance imaging using stack-of-spirals acquisition: a feasibility study in oncology patients. Magn Reson Imaging 2018; 51: 137-143
• 3 Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008; 246 (03) 697-722
• 4 Horeweg N, van Rosmalen J, Heuvelmans MA. et al. Lung cancer probability in patients with CT-detected pulmonary nodules: a prespecified analysis of data from the NELSON trial of low-dose CT screening. Lancet Oncol 2014; 15 (12) 1332-1341
• 5 Wahidi MM, Govert JA, Goudar RK, Gould MK, McCrory DC. American College of Chest Physicians. Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132 (3, Suppl): 94S-107S
• 6 Church TR, Black WC, Aberle DR. et al; National Lung Screening Trial Research Team. Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med 2013; 368 (21) 1980-1991
• 7 Henschke CI, McCauley DI, Yankelevitz DF. et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 1999; 354 (9173): 99-105
• 8 Henschke CI, Yankelevitz DF, Mirtcheva R, McGuinness G, McCauley D, Miettinen OS. ELCAP Group. CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. AJR Am J Roentgenol 2002; 178 (05) 1053-1057
• 9 Swensen SJ, Jett JR, Hartman TE. et al. Lung cancer screening with CT: Mayo Clinic experience. Radiology 2003; 226 (03) 756-761
• 10 Yankelevitz DF, Yip R, Smith JP. et al; International Early Lung Cancer Action Program Investigators Group. CT screening for lung cancer: nonsolid nodules in baseline and annual repeat rounds. Radiology 2015; 277 (02) 555-564
• 11 Sánchez M, Benegas M, Vollmer I. Management of incidental lung nodules <8 mm in diameter. J Thorac Dis 2018; 10 (Suppl. 22) S2611-S2627
• 12 Occhipinti M, Heidinger BH, Pfannenberg C, Munden RF, Eisenberg RL, Bankier AA. Managing incidental lung nodules in patients with a history of oncologic disease: a survey of thoracic radiologists: a survey of thoracic radiologists. J Thorac Imaging 2017; 32 (02) 115-120
• 13 Hammer MM, Mortani Barbosa Jr EJ. Predictive factors for malignancy in incidental pulmonary nodules detected in breast cancer patients at baseline CT. Eur Radiol 2017; 27 (07) 2802-2809
• 14 Parnaby CN, Bailey W, Balasingam A. et al. Pulmonary staging in colorectal cancer: a review. Colorectal Dis 2012; 14 (06) 660-670
• 15 Hu T, Wang S. e X, et al. CT morphological features integrated with whole-lesion histogram parameters to predict lung metastasis for colorectal cancer patients with pulmonary nodules. Front Oncol 2019; 9: 1241
• 16 Munden RF, Erasmus JJ, Wahba H, Fineberg NS. Follow-up of small (4 mm or less) incidentally detected nodules by computed tomography in oncology patients: a retrospective review. J Thorac Oncol 2010; 5 (12) 1958-1962