Magnetic resonance imaging of pulmonary nodules: accuracy in a granulomatous disease–endemic region
- 464 Downloads
To estimate the diagnostic accuracy of signal intensity of the lesion-to-spinal cord ratio (LSR) and apparent diffusion coefficient (ADC) in diffusion-weighted (DW) magnetic resonance imaging of pulmonary nodules suspicious for lung cancer in granulomatous lung disease-endemic regions.
Forty-nine patients with indeterminate solitary pulmonary nodules detected by chest computed tomography and histopathologically confirmed diagnoses were included in the study. DW images were analysed semiquantitatively by focusing regions of interest on the lesion and spinal cord at the same level (for LSR calculation). ADCs were estimated from ratios of the two image signal intensities. Ratios of T1 and T2 signal intensity between nodules and muscle were calculated for comparison.
Mean ADCs ± standard deviations for lung cancer and benign lesions were 0.9 ± 0.2 and 1.3 ± 0.2 × 10-3 mm2/s, respectively. Mean LSRs were 1.4 ± 0.3 for lung cancer and 1 ± 0.1 for benign lesions. ADCs and LSRs differed significantly between malignant and benign lesions (P < 0.001). Mean T2 signal intensity ratios also differed significantly between benign and malignant lesions (0.8 ± 0.2 vs. 1.6 ± 0.2; P < 0.05).
DWI can help to differentiate malignant from benign lesions according to ADC and the LSR with good accuracy.
• DW imaging can help differentiate malignant from benign pulmonary nodules.
• ADC and LSR signal intensities had only small overlap between malignant and benign pulmonary nodules.
• Mean T2 signal intensity ratios differed significantly between benign and malignant lesions.
KeywordsMagnetic resonance imaging Pulmonary nodules Granulomatous disease-endemic region Diffusion weighted Differentiation of malignant from benign lesions
The authors thank Prof. Dr. Hans Ulrich Kauczor for his teachings, availability and great incentive to the development of magnetic resonance imaging of the chest in our country, without whom this study would not be possible. The scientific guarantor of this publication is Bruno Hochhegger. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding.
One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: cross sectional study, performed at one institution.
- 12.Ohno Y, Koyama H, Takenaka D et al (2008) Dynamic MRI, dynamic multidetector-row computed tomography (MDCT), and coregistered 2-[fluorine-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/CT: comparative study of capability for management of pulmonary nodules. J Magn Reson Imaging 27:1284–1295CrossRefPubMedGoogle Scholar