European Radiology

, Volume 19, Issue 2, pp 333–341 | Cite as

Using diffusion-weighted MR imaging for tumor detection in the collapsed lung: a preliminary study

  • Li Ping Qi
  • Xiao Peng ZhangEmail author
  • Lei Tang
  • Jie Li
  • Ying Shi Sun
  • Guang Ying Zhu
Molecular Imaging


The usefulness of diffusion-weighted magnetic resonance (MR) imaging (DWI) for differentiating central lung cancer from postobstructive lobar collapse (POC) was investigated. Thirty-three cases suspected of lung cancer and POC on chest bolus computed tomography (CT) underwent thoracic MR imaging examinations. MR examinations were performed using a 1.5-T clinical scanner. Scanning sequences were T1-weighted imaging, T2-weighted imaging (T2WI) and DWI with b = 0, 500 s/mm2, four excitations and segmented breath-holding. The densities and signals of cancer and postobstructive collapsed lung were compared on bolus-enhanced CT, T2W and DW images. Statistical analyses were performed with chi-square test, paired t-test, non-parameter test and kappa statistics. Differentiation between cancer and POC was possible on bolus CT, T2W and DW images in 14, 21 and 26 patients, respectively. Eight cases that were impossible to differentiate on T2W images were distinguishable on DWI, demonstrating that DWI is complementary to T2WI. Using a combination of T2W and DW images, 88% (29/33) of cases were differentiated on MR imaging. Thus, a combination of T2W and DW imaging is superior to bolus-CT or T2WI alone. The contrast-to-noise ratio of DWI was significantly higher than that of T2WI. Agreement between two independent observers on the differential ability of lung cancer and POC was higher for DWI (kappa = 0.474) than for T2WI (kappa = 0.339). The degree of consolidation around the cancer was negatively correlated with the degree of artifact and degree of deformation. It is feasible to use DWI to differentiate lung cancer from POC. DWI played a role in confirming and providing complementary information to that obtained from T2WI. Our data indicate that using a combination of the two scanned sequences was the best means of distinguishing between lung cancer and POC.


Lung neoplasm Diffusion-weighted imaging Differentiation Atelectasis Magnetic resonance imaging 



We thank Amrita Rajagopalan, a biomedical engineer from TeraRecon Inc (2955 Campus Drive, Suite 325 San Mateo, CA 94403, USA) and Hongwei Tang, a clinical application specialist from TeraRecon for extensively revising the manuscript. This work was supported by the National Basic Research Program of China (973 Program) (No. 2006CB705706).


  1. 1.
    Bourgouin PM, McLoud TC, Fitzgibbon JF, Mark EJ, Shepard JA, Moore EM, Rummeny E, Brady TJ (1991) Differentiation of bronchogenic carcinoma from postobstructive pneumonitis by magnetic resonance imaging: histopathologic correlation. J Thorac Imaging 6:22–27PubMedCrossRefGoogle Scholar
  2. 2.
    Shioya S, Haida M, Ono Y, Fukuzaki M, Yamabayashi H (1988) Lung cancer: differentiation of tumor, necrosis, and atelectasis by means of T1 and T2 values measured in vitro. Radiology 167:105–109PubMedGoogle Scholar
  3. 3.
    Tobler J, Levitt RG, Glazer HS, Moran J, Crouch E, Evans RG (1987) Differentiation of proximal bronchogenic carcinoma from postobstructive lobar collapse by magnetic resonance imaging. Comparison with computed tomography. Invest Radiol 22:538–543PubMedCrossRefGoogle Scholar
  4. 4.
    Onitsuka H, Tsukuda M, Araki A, Murakami J, Torii Y, Masuda K (1991) Differentiation of central lung tumor from postobstructive lobar collapse by rapid sequence computed tomography. J Thorac Imaging 6:28–31PubMedCrossRefGoogle Scholar
  5. 5.
    Stiglbauer R, Schurawitzki H, Klepetko W, Kramer J, Schratter M, Tscholakoff D, Eckersberger F (1991) Contrast-enhanced MRI for the staging of bronchogenic carcinoma: comparison with CT and histopathologic staging–preliminary results. Clin Radiol 44:293–298PubMedCrossRefGoogle Scholar
  6. 6.
    Glazer HS, Anderson DJ, Sagel SS (1989) Bronchial impaction in lobar collapse: CT demonstration and pathologic correlation. AJR Am J Roentgenol 153:485–488PubMedGoogle Scholar
  7. 7.
    Atsushi K, Mitsutaka F, Naoki A, Naoko Y, Shoji Y (1998) Using Two-Phase Tl-201 SPECT and modified retention image to view tumor in the collapsed lung: Comparison with Bolus CT. Clin Nucl Med 23:657–663CrossRefGoogle Scholar
  8. 8.
    Kim HJ, Choi CG, Lee DH, Lee JH, Kim SJ, Suh DC (2005) High-b-value diffusion-weighted MR imaging of hyperacute ischemic stroke at 1.5T. AJNR Am J Neuroradiol 26:208–215PubMedGoogle Scholar
  9. 9.
    Reddy JS, Mishra AM, Behari S, Husain M, Gupta V, Rastogi M, Gupta RK (2006) The role of diffusion-weighted imaging in the differential diagnosis of intracranial cystic mass lesions: a report of 147 lesions. Surg Neurol 66:246–250PubMedCrossRefGoogle Scholar
  10. 10.
    Higano S, Yun X, Kumabe T, Watanabe M, Mugikura S, Umetsu A, Sato A, Yamada T, Takahashi S (2006) Malignant astrocytic tumors: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology 241:839–846PubMedCrossRefGoogle Scholar
  11. 11.
    Guo Y, Cai YQ, Cai ZL (2002) Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging. J Magn Reson Imaging 16:172–178PubMedCrossRefGoogle Scholar
  12. 12.
    Quan XY, Sun XJ, Yu ZJ, Tang M (2005) Evaluation of diffusion weighted imaging of magnetic resonance imaging in small focal hepatic lesions: a quantitative study in 56 cases. Hepatobiliary Pancreat Dis Int 4:406–409PubMedGoogle Scholar
  13. 13.
    Sato C, Naganawa S, Nakamura T, Kumada H, Miura S, Takizawa O, Ishigaki T (2005) Differentiation of noncancerous tissue and cancer lesions by apparent diffusion coefficient values in transition and peripheral zones of the prostate. J Magn Reson Imaging 21:258–262PubMedCrossRefGoogle Scholar
  14. 14.
    Hosonuma T, Tozaki M, Ichiba N (2006) Clinical usefulness of diffusion-weighted imaging using low and high b-values to detect rectal cancer. Magn Reson Med Sci 5:173–177PubMedCrossRefGoogle Scholar
  15. 15.
    Altes TA, Mata J, Lange EE, Brookeman JR, Mugler JP III (2006) Assessment of lung development using hyperpolarized helium-3 diffusion MR imaging. J Magn Reson Imaging 24:1277–1283PubMedCrossRefGoogle Scholar
  16. 16.
    Matoba M, Tonami H, Kondou T, Yokota H, Higashi K, Toga H, Sakuma T (2007) Lung carcinoma: Diffusion weighted MR imaging—preliminary evaluation with apparent diffusion coefficient. Radiology 243:570–577PubMedCrossRefGoogle Scholar
  17. 17.
    Cicchetti DV, Sparrow SS (1981) Developing criteria for establishing interrator reliability of specific items: application to assessment of adaptive behavior. Am J Ment Defic 86:127–137PubMedGoogle Scholar
  18. 18.
    Plathow C, Hof H, Kuhn S, Puderbach M, Ley S, Biederer J, Claussen CD, Huber PE, Schaefer J, Tuengerthal S, Kauczor HU (2006) Therapy monitoring using dynamic MRI: analysis of lung motion and intrathoracic tumor mobility before and after radiotherapy. Eur Radiol 16:1942–1950PubMedCrossRefGoogle Scholar
  19. 19.
    Ohno Y, Adachi S, Kono M, Kusumoto M, Motoyama A, Sugimura K (2000) Predicting the prognosis of non-small cell lung cancer patient treated with conservative therapy using contrast-enhanced MR imaging. Eur Radiol 10:1770–1781PubMedCrossRefGoogle Scholar
  20. 20.
    Benveniste H, Hedlund LW, Johnson GA (1992) Mechanism of detection of acute cerebral ischemia in rats by diffusion-weighted magnetic resonance microscopy. Stroke 23:746–754PubMedGoogle Scholar
  21. 21.
    Herneth AM, Guccione S, Bednarski M (2003) Apparent diffusion coefficient: a quantitative parameter for in vivo tumor characterization. Eur J Radiol 45:208–213PubMedCrossRefGoogle Scholar
  22. 22.
    Abdel Razek AA (2006) Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol 16:1468–1477PubMedCrossRefGoogle Scholar
  23. 23.
    Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A, Gourtsoyiannis N (2008) Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 18:486–492PubMedCrossRefGoogle Scholar
  24. 24.
    Bruegel M, Holzapfel K, Gaa J, Woertler K, Waldt S, Kiefer B, Stemmer A, Ganter C, Rummeny EJ (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18:477–485PubMedCrossRefGoogle Scholar
  25. 25.
    Tamai K, Koyama T, Saga T, Morisawa N, Fujimoto K, Mikami Y, Togashi K (2008) The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol 18:723–730PubMedCrossRefGoogle Scholar
  26. 26.
    Dietrich O, Raya JG, Reeder SB, Reiser MF, Schoenberg SO (2007) Measurement of signal-to-noise ratios in MR images: influence of multichannel coils, parallel imaging, and reconstruction filters. J Magn Reson Imaging 26:375–385PubMedCrossRefGoogle Scholar
  27. 27.
    Nasu K, Kuroki Y, Kuroki S, Murakami K, Nawano S, Moriyama N (2004) Diffusion-weighted single shot echo planar imaging of colorectal cancer using a sensitivity-encoding technique. Jpn J Clin Oncol 34:620–626PubMedCrossRefGoogle Scholar
  28. 28.
    Bammer R (2003) Basic principles of diffusion weighted imaging. Eur J Radiol 45:169–184PubMedCrossRefGoogle Scholar
  29. 29.
    Tang L, Zhang XP, Sun YS, Li Y (2005) Diffusion-weighted MR imaging of gastric cancer: study of parallel imaging combined with separate breathholds and multi-NEX technique. Chin J Med Imaging Technol 21:1830–1834Google Scholar
  30. 30.
    Erdia YE, Rosenzweigb K, Erdia AK, Macapinlacc HA (2002) Radiotherapy treatment planning for patients with non-small cell lung cancer using positron emission tomography (PET). Radiother Oncol 62:51–60CrossRefGoogle Scholar
  31. 31.
    Bradley J, Thorstad WL, Mutic S, Miller TR, Dehdashti F, Siegel BA, Bosch W, Bertrand RJ (2004) Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 59:78–86PubMedGoogle Scholar
  32. 32.
    Steinert HC (2005) PET in lung cancer. Chang Gung Med J 28:296–305PubMedGoogle Scholar

Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Li Ping Qi
    • 1
  • Xiao Peng Zhang
    • 1
    Email author
  • Lei Tang
    • 1
  • Jie Li
    • 1
  • Ying Shi Sun
    • 1
  • Guang Ying Zhu
    • 2
  1. 1.Department of RadiologyPeking University School of Oncology, Beijing Cancer Hospital & InstituteBeijingChina
  2. 2.Department of RadiotherapyPeking University School of Oncology, Beijing Cancer Hospital & InstituteBeijingChina

Personalised recommendations