Skip to main content

Advertisement

SpringerLink
Log in

Lung MRI of invasive fungal infection at 3 Tesla: evaluation of five different pulse sequences and comparison with multidetector computed tomography (MDCT)

  • Chest
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the diagnostic performance of five MR sequences to detect pulmonary infectious lesions in patients with invasive fungal infection (IFI), using multidetector computed tomography (MDCT) as the reference standard.

Methods

Thirty-four immunocompromised patients with suspected IFI underwent MDCT and MRI. The MR studies were performed using five pulse sequences at 3.0 T: T2-weighted turbo spin echo (TSE), short-tau inversion recovery (STIR), spectrally selective attenuated inversion recovery (SPAIR), T1-weighted high resolution isotropic volume excitation (e-THRIVE) and T1-weighted fast field echo (T1-FFE). The size, lesion-to-lung contrast ratio and the detectability of pulmonary lesions on MR images were assessed. Image quality and artefacts on different sequences were also rated.

Results

A total of 84 lesions including nodules (n = 44) and consolidation (n = 40) were present in 75 lobes. SPAIR and e-THRIVE images achieved high overall lesion-related sensitivities for the detection of pulmonary abnormalities (90.5 % and 86.9 %, respectively). STIR showed the highest lesion-to-lung contrast ratio for nodules (21.8) and consolidation (17.0), whereas TSE had the fewest physiological artefacts.

Conclusions

MRI at 3.0 T can depict clinically significant pulmonary IFI abnormalities with high accuracy compared to MDCT. SPAIR and e-THRIVE are preferred sequences for the detection of infectious lesions of 5 mm and larger.

Key Points

• A radiation-free radiological method is desirable for assessing pulmonary infectious lesions

• MRI at 3 T can depict lung infiltrates with good concordance to MDCT

• SPAIR and e-THRIVE are favourable sequences for the detection of pulmonary lesions

• The greatest benefit is for the diagnosis of lesions larger than 5 mm

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

e-THRIVE:

T1-weighted high resolution isotropic volume excitation

HU:

Hounsfield unit

IFI:

Invasive fungal infection

MDCT:

Multidetector computed tomography

RT:

Respiratory triggered

SPAIR:

Spectrally selective attenuated inversion recovery

STIR:

Short-tau inversion recovery

T1-FFE:

T1-weighted fast field echo

TSE:

Turbo spin echo

References

  1. Maschmeyer G, Haas A, Cornely OA (2007) Invasive aspergillosis: epidemiology, diagnosis and management in immunocompromised patients. Drugs 67:1567–1601

    Article  CAS  PubMed  Google Scholar 

  2. Li Y, Xu W, Jiang Z et al (2014) Neutropenia and invasive fungal infection in patients with hematological malignancies treated with chemotherapy: a multicenter, prospective, non-interventional study in China. Tumour Biol 35:5869–5876

    Article  CAS  PubMed  Google Scholar 

  3. Karthaus M, Buchheidt D (2013) Invasive aspergillosis: new insights into disease, diagnostic and treatment. Curr Pharm Des 19:3569–3594

    Article  CAS  PubMed  Google Scholar 

  4. Walsh TJ, Anaissie EJ, Denning DW et al (2008) Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 46:327–360

    Article  CAS  PubMed  Google Scholar 

  5. Kuhlman JE, Fishman EK, Burch PA, Karp JE, Zerhouni EA, Siegelman SS (1987) Invasive pulmonary aspergillosis in acute leukemia. The contribution of CT to early diagnosis and aggressive management. Chest 92:95–99

    Article  CAS  PubMed  Google Scholar 

  6. Puderbach M, Kauczor HU (2008) Can lung MR replace lung CT? Pediatr Radiol 38:S439–S451

    Article  PubMed  Google Scholar 

  7. Sieren JC, Ohno Y, Koyama H, Sugimura K, McLennan G (2010) Recent technological and application developments in computed tomography and magnetic resonance imaging for improved pulmonary nodule detection and lung cancer staging. J Magn Reson Imaging 32:1353–1369

    Article  PubMed Central  PubMed  Google Scholar 

  8. Koyama H, Ohno Y, Kono A et al (2008) Quantitative and qualitative assessment of non-contrast-enhanced pulmonary MR imaging for management of pulmonary nodules in 161 subjects. Eur Radiol 18:2120–2131

    Article  PubMed  Google Scholar 

  9. Lutterbey G, Gieseke J, von Falkenhausen M, Morakkabati N, Schild H (2005) Lung MRI at 3.0 T: a comparison of helical CT and high-field MRI in the detection of diffuse lung disease. Eur Radiol 15:324–328

    Article  CAS  PubMed  Google Scholar 

  10. Bruegel M, Gaa J, Woertler K et al (2007) MRI of the lung: value of different turbo spin-echo, single-shot turbo spin-echo, and 3D gradient-echo pulse sequences for the detection of pulmonary metastases. J Magn Reson Imaging 25:73–81

    Article  PubMed  Google Scholar 

  11. Fink C, Puderbach M, Biederer J et al (2007) Lung MRI at 1.5 and 3 Tesla: observer preference study and lesion contrast using five different pulse sequences. Invest Radiol 42:377–383

    Article  PubMed  Google Scholar 

  12. Frericks BB, Meyer BC, Martus P, Wendt M, Wolf KJ, Wacker F (2008) MRI of the thorax during whole-body MRI: evaluation of different MR sequences and comparison to thoracic multidetector computed tomography (MDCT). J Magn Reson Imaging 27:538–545

    Article  PubMed  Google Scholar 

  13. Puderbach M, Hintze C, Ley S, Eichinger M, Kauczor HU, Biederer J (2007) MR imaging of the chest: a practical approach at 1.5 T. Eur J Radiol 64:345–355

    Article  CAS  PubMed  Google Scholar 

  14. Attenberger UI, Morelli JN, Henzler T et al (2013) 3Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: initial results in comparison to HRCT. Eur J Radiol 83:e61–e66

    Article  PubMed  Google Scholar 

  15. De Pauw B, Walsh TJ, Donnelly JP et al (2008) Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46:1813–1821

    Article  PubMed Central  PubMed  Google Scholar 

  16. Schroeder T, Ruehm SG, Debatin JF, Ladd ME, Barkhausen J, Goehde SC (2005) Detection of pulmonary nodules using a 2D HASTE MR sequence: comparison with MDCT. AJR Am J Roentgenol 185:979–984

    Article  PubMed  Google Scholar 

  17. Eibel R, Herzog P, Dietrich O et al (2006) Pulmonary abnormalities in immunocompromised patients: comparative detection with parallel acquisition MR imaging and thin-section helical CT. Radiology 241:880–891

    Article  PubMed  Google Scholar 

  18. Udayasankar UK, Martin D, Lauenstein T et al (2008) Role of spectral presaturation attenuated inversion-recovery fat-suppressed T2-weighted MR imaging in active inflammatory bowel disease. J Magn Reson Imaging 28:1133–1140

    Article  PubMed  Google Scholar 

  19. Lauenstein TC, Sharma P, Hughes T, Heberlein K, Tudorascu D, Martin DR (2008) Evaluation of optimized inversion-recovery fat-suppression techniques for T2-weighted abdominal MR imaging. J Magn Reson Imaging 27:1448–1454

    Article  PubMed  Google Scholar 

  20. Koyama H, Ohno Y, Aoyama N et al (2010) Comparison of STIR turbo SE imaging and diffusion-weighted imaging of the lung: capability for detection and subtype classification of pulmonary adenocarcinomas. Eur Radiol 20:790–800

    Article  PubMed  Google Scholar 

  21. Yi CA, Jeon TY, Lee KS et al (2007) 3-T MRI: usefulness for evaluating primary lung cancer and small nodules in lobes not containing primary tumors. AJR Am J Roentgenol 189:386–392

    Article  PubMed  Google Scholar 

  22. Fischbach F, Lohfink K, Gaffke G et al (2013) Magnetic resonance-guided freehand radiofrequency ablation of malignant liver lesions: a new simplified and time-efficient approach using an interactive open magnetic resonance scan platform and hepatocyte-specific contrast agent. Invest Radiol 48:422–428

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The scientific guarantor of this publication is Prof. Yikai Xu. The authors of this manuscript declare relationships with the following companies: Philips Electronics Ltd. One co-author (Queenie Chan) is an employee of Philips Electronics Hong Kong Ltd. Dr. Chan contributed to designing the study, the establishment of the radiology project, and editing and revising the manuscript. The authors state that this work has not received any funding. Prof. Xuhui Tan kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. None of the study subjects or cohorts have been previously reported. Methodology: prospective, diagnostic study, performed at one institution.

Author information

Authors and Affiliations

  1. Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, People’s Republic of China

    Chenggong Yan, Xiangliang Tan, Caixia Li, Yuankui Wu, Peng Hao, Wei Xiong & Yikai Xu

  2. Department of Hematology, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, People’s Republic of China

    Qi Wei, Ru Feng & Jun Xu

  3. Philips Healthcare, Science Park East Avenue, Hong Kong Science Park, New Territories, Hong Kong

    Queenie Chan

Authors
  1. Chenggong Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiangliang Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qi Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ru Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Caixia Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuankui Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Peng Hao
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Queenie Chan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wei Xiong
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jun Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yikai Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yikai Xu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yan, C., Tan, X., Wei, Q. et al. Lung MRI of invasive fungal infection at 3 Tesla: evaluation of five different pulse sequences and comparison with multidetector computed tomography (MDCT). Eur Radiol 25, 550–557 (2015). https://doi.org/10.1007/s00330-014-3432-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-014-3432-2

Keywords

Search

Navigation