Lung cancer screening with MRI: results of the first screening round
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To evaluate the suitability of MRI for lung cancer screening in a high-risk population.
Materials and methods
A 5-year lung cancer screening program comparing MRI and low-dose CT (LDCT) in a high-risk population was initiated. 224 subjects were examined with MRI and LDCT. Acquired MRI sequences were T2w MultiVane XD, balanced steady-state-free precession, 3D T1w GRE, and DWI with a maximum in-room-time of 20 min. Categorization and management of nodules were based on Lung-RADS. MRI findings were correlated with LDCT as a reference. Here, we report on the first screening round.
MRI accurately detected 61 of 88 nodules 4–5 mm, 20 of 21 nodules 6–7 mm, 12 of 12 nodules 8–14 mm, 4 of 4 nodules ≥ 15 mm (solid nodules), and 8 of 11 subsolid nodules. Sensitivity/specificity of MRI for nodule detection was 69.3/96.4% for 4–5 mm, 95.2/99.6% for 6–7 mm, 100/99.6% for 8–14 mm, 100/100% for ≥ 15 mm (solid nodules), and 72.7/99.2% for subsolid nodules. The early recall rate was 13.8% for MRI and 12.5% for LDCT. Following Lung-RADS recommendations and based on interdisciplinary consensus, histology was obtained in eight subjects. The biopsy rate was 3.6% for MRI and 3.4% for LDCT. In all of these eight cases, the nodules were carcinomas, and all of them were accurately detected by MRI.
The results of the first screening round suggest that MRI is suitable for lung cancer screening with an excellent sensitivity and specificity for nodules ≥ 6 mm.
KeywordsLung cancer Screening MRI
Low-dose computed tomography
Lung screening reporting and data system
MultiVane XD (Philips Healthcare, Best, The Netherlands)
Sensitivity encoding (Philips Healthcare, Best, The Netherlands)
Short tau inversion recovery
T1 high-resolution isotropic volume excitation (Philips Healthcare, Best, The Netherlands)
Ultrashort echo time
We would like to address special thanks to our study nurse Olga Ramig. This study would not have been achievable without her ambition.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- American College of Radiology (2017) Lung CT screening reporting and data system (Lung-RADS). Available at: http://www.acr.org/Quality-Safety/Resources/LungRADS. Accessed 31 March 2017
- Cieszanowski A, Lisowska A, Dabrowska M, Korczynski P, Zukowska M, Grudzinski IP, Pacho R, Rowinski O, Krenke R (2016) MR imaging of pulmonary nodules: detection rate and accuracy of size estimation in comparison to computed tomography. PLoS One 11(6):e0156272CrossRefPubMedPubMedCentralGoogle Scholar
- Deng Y, Li X, Lei Y, Liang C, Liu Z (2016) Use of diffusion-weighted magnetic resonance imaging to distinguish between lung cancer and focal inflammatory lesions: a comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient. Acta Radiol 57(11):1310–1317CrossRefPubMedGoogle Scholar
- Koyama H, Ohno Y, Aoyama N, Onishi Y, Matsumoto K, Nogami M, Takenaka D, Nishio W, Ohbayashi C, Sugimura K (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 20:790–800CrossRefPubMedGoogle Scholar
- Lung cancer (2012) Estimated incidence, mortality and prevalence worldwide in 2012. Available at http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed 31 March 2017
- National Collaborating Centre for Cancer (UK) (2011) The diagnosis and treatment of lung cancer (Update). Cardiff (UK): National Collaborating Centre for Cancer (UK). NICE Clinical Guidelines, No. 121Google Scholar
- Ohno Y, Koyama H, Yoshikawa T, Seki S, Takenaka D, Yui M, Lu A, Miyazaki M, Sugimura K (2016) Pulmonary high-resolution ultrashort TE MR imaging: comparison with thin-section standard- and low-dose computed tomography for the assessment of pulmonary parenchyma diseases. J Magn Reson Imaging 43(2):512–532CrossRefPubMedGoogle Scholar
- Sommer G, Tremper J, Koenigkam-Santos M, Delorme S, Becker N, Biederer J, Kauczor HU, Heussel CP, Schlemmer HP, Puderbach M (2014) Lung nodule detection in a high-risk population: comparison of magnetic resonance imaging and low-dose computed tomography. Eur J Radiol 83(3):600–605CrossRefPubMedGoogle Scholar