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MR imaging of pulmonary lung nodules during one lung flooding: first morphological evaluation using an ex vivo human lung model

  • Frank WolframEmail author
  • Joachim Böttcher
  • Thomas Günther Lesser
Research Article
  • 3 Downloads
Part of the following topical collections:
  1. Basic Science - Preclinical imaging

Abstract

Objectives

Magnetic resonance imaging in pulmonary oncology is limited because of unfavourable physical and physiological conditions in ventilated lung. Previous work showed operability of One Lung Flooding using saline in vivo in MR units, and that valuable conditions for ultrasound and thermal-based interventions exist. Therefore, this study investigates the morphological details of human lung during Lung Flooding to evaluate its further value focusing on MR-guided interventions.

Materials and methods

MR imaging was performed on 20 human lung lobes containing lung cancer and metastases. Lobes were intraoperatively flooded with saline and imaged using T1w Gradient Echo and T2 Spin Echo sequences at 1.5 T. Additionally, six patients received pre-operative MRI.

Results

During lung flooding, all lung tumours and metastases were visualized and clearly demarked from the surrounding lung parenchyma. The tumour mass appeared hyperintense in T1w and hypointense in T2w MR imaging. Intra-pulmonary bronchial structures were well differentiated in T2w and calcification in T1w MR sequences.

Conclusion

Superior conditions with new features of lung MRI were found during lung flooding with an unrestricted visualization of malignant nodules and clear demarcation of intra-pulmonary structures. This could lead to new applications of MR-based pulmonary interventions such as laser or focused ultrasound-based thermal ablations.

Keywords

MRI One lung flooding Lung imaging Lung cancer MR intervention HIFU 

Abbreviations

ADC

Adeno carcinoma

BAC

Bronco alveolar carcinoma

CNR

Contrast-to-noise ratio

CRC

Colorectal carcinoma

CT

Computer tomography

FA

Flip angle

FIO2

Fraction inspired oxygen

FUS

Focused ultrasound surgery

GRE

Gradient echo

HASTE

Half-Fourier acquisition single-shot turbo spin echo sequence

HIFU

High-intensity focused ultrasound

IDC

Invasive mammary ductal carcinoma

LC

Lung cancer

LCC

Large-cell carcinoid

LUL

Left upper lobe

LLL

Left lower lobe

LMTS

Lung metastasis

MIP

Maximum intensity projection

MRI

Magnet resonance imaging

NSCLC

Non-small cell lung cancer

OLF

One lung flooding

PET

Positron emission tomography

PDC

Pancreatic ductal carcinoma

PTFE

Polytetrafluoroethylene

PFC

PerFluoroCarbonate liquid

RCC

Renal cell carcinoma

PP

Polypropylene

RML

Right middle lobe

RUL

Right upper lobe

RLL

Right lower lobe

ROI

Region of interest

SAR

Specific absorption rate

SQC

Squamous carcinoma

TE

Echo time

TR

Repetition time

Notes

Author contributions

FW and TGL developed the study design and conception. TGL performed clinical selection of cases and performed surgical resection. FW performed ex vivo lung preparation. Acquisition of MR data and statistics were performed by JB and FW. FW, JB, and TGL were drafting the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests, neither financial nor non-financial. This research was supported by the FUS Foundation, Charlottesville, VA, USA (FUS325) and the SRH Waldklinikum Gera, Germany.

Ethic approval

All surgical procedures were performed at the clinic for thoracic and vascular surgery of the SRH Wald-Klinikum Gera, Germany. The use of human tissue for this study was approved by the ethics committee of the Medical Association of Thuringia (TLLV) and patients were informed prior to surgery. This article does not contain any studies with animals performed by any of the authors.

Supplementary material

10334_2020_826_MOESM1_ESM.avi (263 kb)
Supplementary file1 (AVI 263 kb)

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Copyright information

© European Society for Magnetic Resonance in Medicine and Biology (ESMRMB) 2020

Authors and Affiliations

  1. 1.Department of Thoracic and Vascular Surgery, SRH Wald-Klinikum GeraTeaching Hospital of Friedrich-Schiller University of JenaGeraGermany
  2. 2.Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum GeraTeaching Hospital of Friedrich-Schiller University of JenaGeraGermany

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