Characterisation of solitary pulmonary lesions combining visual perfusion and quantitative diffusion MR imaging
- 879 Downloads
To evaluate the diagnostic accuracy of dynamic contrast-enhanced (DCE) magnetic resonance (MR) and diffusion-weighted imaging (DWI) sequences for defining benignity or malignancy of solitary pulmonary lesions (SPL).
First, 54 consecutive patients with SPL, clinically staged (CT and PET or integrated PET-CT) as N0M0, were included in this prospective study. An additional 3-Tesla MR examination including DCE and DWI was performed 1 day before the surgical procedure. Histopathology of the surgical specimen served as the standard of reference. Subsequently, this functional method of SPL characterisation was validated with a second cohort of 54 patients.
In the feasibility group, 11 benign and 43 malignant SPL were included. Using the combination of conventional MR sequences with visual interpretation of DCE-MR curves resulted in a sensitivity, specificity and accuracy of 100 %, 55 % and 91 %, respectively. These results can be improved by DWI (with a cut-off value of 1.52 × 10−3 mm2/s for ADChigh) leading to a sensitivity, specificity and accuracy of 98 %, 82 % and 94 %, respectively. In the validation group these results were confirmed.
Visual DCE-MR-based curve interpretation can be used for initial differentiation of benign from malignant SPL, while additional quantitative DWI-based interpretation can further improve the specificity.
• Magnetic resonance imaging is increasingly being used to help differentiate lung lesions.
• Solitary pulmonary lesions (SPL) are accurately characterised by combining DCE-MRI and DWI.
• Visual DCE-MRI assessment facilitates the diagnostic throughput in patients with SPL.
• DWI provides additional information in inconclusive DCE-MRI (type B pattern).
KeywordsSingle pulmonary lesion Magnetic resonance imaging Diffusion-weighted imaging Dynamic contrast-enhanced MR imaging Characterisation of lung nodule or mass
- 35.Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2010) In: Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (eds) AJCC cancer staging manual, 7th edn. Springer, New York, pp 232–250Google Scholar