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Pulmonary MRI with ultra-short TE using single- and dual-echo methods: comparison of capability for quantitative differentiation of non- or minimally invasive adenocarcinomas from other lung cancers with that of standard-dose thin-section CT

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Abstract

Objective

The purpose of this study was thus to compare capabilities for quantitative differentiation of non- and minimally invasive adenocarcinomas from other of pulmonary MRIs with ultra-short TE (UTE) obtained with single- and dual-echo techniques (UTE-MRISingle and UTE-MRIDual) and thin-section CT for stage IA lung cancer patients.

Methods

Ninety pathologically diagnosed stage IA lung cancer patients who underwent thin-section standard-dose CT, UTE-MRISingle, and UTE-MRIDual, surgical treatment and pathological examinations were included in this retrospective study. The largest dimension (Dlong), solid portion (solid Dlong), and consolidation/tumor (C/T) ratio of each nodule were assessed. Two-tailed Student’s t-tests were performed to compare all indexes obtained with each method between non- and minimally invasive adenocarcinomas and other lung cancers. Receiver operating characteristic (ROC)-based positive tests were performed to determine all feasible threshold values for distinguishing non- or minimally invasive adenocarcinoma (MIA) from other lung cancers. Sensitivity, specificity, and accuracy were then compared by means of McNemar’s test.

Results

Each index showed significant differences between the two groups (p < 0.0001). Specificities and accuracies of solid Dlong for UTE-MRIDual2nd echo and CTMediastinal were significantly higher than those of solid Dlong for UTE-MRISingle and UTE-MRIDual1st echo and all C/T ratios except CTMediastinal (p < 0.05). Moreover, the specificities and accuracies of solid Dlong and C/T ratio were significantly higher than those of Dlong for each method (p < 0.05).

Conclusion

Pulmonary MRI with UTE is considered at least as valuable as thin-section CT for quantitative differentiation of non- and minimally invasive adenocarcinomas from other stage IA lung cancers.

Clinical relevance statement

Pulmonary MRI with UTE’s capability for quantitative differentiation of non- and minimally invasive adenocarcinomas from other lung cancers in stage IA lung cancer patients is equal or superior to that of thin-section CT.

Key Points

• Correlations were excellent for pathologically examined nodules with the largest dimensions (Dlong) and a solid component (solid Dlong) for all indexes (0.95 ≤ r ≤ 0.99, p < 0.0001).

• Pathologically examined Dlong and solid Dlong obtained with all methods showed significant differences between non- and minimally invasive adenocarcinomas and other lung cancers (p < 0.0001).

• Solid tumor components are most accurately measured by UTE-MRIDual2nd echo and CTMediastinal, whereas the ground-glass component is imaged by UTE-MRIDual1st echo and CTlung with high accuracy. UTE-MRIDual predicts tumor invasiveness with 100% sensitivity and 87.5% specificity at a C/T threshold of 0.5.

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Abbreviations

C/T ratio:

Consolidation/tumor ratio

CTLung :

Thin-section standard-dose CT at lung window setting

CTMediastinal :

Thin-section standard-dose CT at mediastinal window setting

Dlong :

The largest dimension of each nodule

Lung-RADS:

Lung Imaging Reporting and Data System

solid Dlong :

The largest dimension of each nodule’s solid portion

UTE:

Ultrashort echo time

UTE-MRIDual1st echo :

Pulmonary MRI with ultra-short TE using dual-echo technique at first echo

UTE-MRIDual2nd echo :

Pulmonary MRI with ultra-short TE using dual-echo technique at second echo

UTE-MRISingle :

Pulmonary MRI with ultra-short TE using single-echo technique

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Funding

Drs. Ohno, Nagata, and Toyama received a research grant from Canon Medical Systems Corporation, which also supported this work technically. Drs. Ohno and Takenaka received a research grant from Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; No. 18K07675). Drs. Ohno and Toyama received research grants from Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; No. 20K08037), and the Smoking Research Foundation.

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan

    Yoshiharu Ohno

  2. Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Yoshiharu Ohno & Hiroyuki Nagata

  3. Canon Medical Systems Corporation, Otawara, Tochigi, Japan

    Masao Yui, Kaori Yamamoto & Masato Ikedo

  4. Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan

    Yuka Oshima, Nayu Hamabuchi, Satomu Hanamatsu, Takahiro Ueda, Hirotaka Ikeda, Daisuke Takenaka, Takeshi Yoshikawa, Yoshiyuki Ozawa & Hiroshi Toyama

  5. Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan

    Daisuke Takenaka & Takeshi Yoshikawa

  6. Department of Radiology, Nagoya City University Graduate School of Medicine, Nagoya, Aichi, Japan

    Yoshiyuki Ozawa

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  1. Yoshiharu Ohno
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Corresponding author

Correspondence to Yoshiharu Ohno.

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Guarantor

The scientific guarantor of this publication is Yoshiharu Ohno, MD, PhD.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Canon Medical Systems Corporation, Smoking Research Foundation, and Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology.

Drs. Ohno, Nagata, and Toyama received a research grant from Canon Medical Systems Corporation, which also supported this work technically. Drs. Ohno and Takenaka received a research grant from Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; No. 18K07675).

Drs. Ohno and Toyama received research grants from Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; No. 20K08037) and Smoking Research Foundation. Ms. Kaori Yamamoto, RT, Mr. Masato Ikedo, Meng, and Mr. Masao Yui, MS, are employees of Canon Medical Systems Corporation, who had no control over any data or information submitted for publication nor any control over any parts of data or information included in this study.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

This retrospective study was approved by the Institutional Review Board of Fujita Health University Hospital and is compliant with the Health Insurance Portability and Accountability Act. Written informed consent was waived.

Ethical approval

This retrospective study was approved by the Institutional Review Board of Fujita Health University Hospital and is compliant with the Health Insurance Portability and Accountability Act. Written informed consent was waived.

Study subjects or cohorts overlap

This study was not overlapped with any study cohort.

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  • retrospective study

  • observational

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Ohno, Y., Yui, M., Yamamoto, K. et al. Pulmonary MRI with ultra-short TE using single- and dual-echo methods: comparison of capability for quantitative differentiation of non- or minimally invasive adenocarcinomas from other lung cancers with that of standard-dose thin-section CT. Eur Radiol 34, 1065–1076 (2024). https://doi.org/10.1007/s00330-023-10105-4

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