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European Radiology

, Volume 26, Issue 9, pp 2915–2920 | Cite as

Magnetic resonance imaging of pulmonary nodules: accuracy in a granulomatous disease–endemic region

  • Natália Henz ConcattoEmail author
  • Guilherme Watte
  • Edson Marchiori
  • Klaus Irion
  • José Carlos Felicetti
  • José Jesus Camargo
  • Bruno Hochhegger
Magnetic Resonance

Abstract

Objective

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.

Methods

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.

Results

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).

Conclusions

DWI can help to differentiate malignant from benign lesions according to ADC and the LSR with good accuracy.

Key Points

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.

Keywords

Magnetic resonance imaging Pulmonary nodules Granulomatous disease-endemic region Diffusion weighted Differentiation of malignant from benign lesions 

Notes

Acknowledgments

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.

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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Natália Henz Concatto
    • 1
    • 7
    Email author
  • Guilherme Watte
    • 2
  • Edson Marchiori
    • 3
  • Klaus Irion
    • 4
  • José Carlos Felicetti
    • 5
  • José Jesus Camargo
    • 5
  • Bruno Hochhegger
    • 6
  1. 1.University of Caxias do SulCaxias do SulBrazil
  2. 2.Medical Imaging Research LaboratoryFederal University of Health Sciences of Porto AlegrePorto AlegreBrazil
  3. 3.Department of RadiologyFederal University of Rio de JaneiroRio de JaneiroBrazil
  4. 4.Department of RadiologyLiverpool Heart and Chest Hospital NHS Foundation TrustLiverpoolUK
  5. 5.Department of Thoracic SurgerySanta Casa Hospital ComplexPorto AlegreBrazil
  6. 6.Department of RadiologySanta Casa Hospital ComplexPorto AlegreBrazil
  7. 7.Caxias do SulBrazil

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