Abstract
Purpose
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.
Results
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.
Conclusion
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.
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Abbreviations
- DWI:
-
Diffusion-weighted imaging
- LDCT:
-
Low-dose computed tomography
- Lung-RADS:
-
Lung screening reporting and data system
- MVXD:
-
MultiVane XD (Philips Healthcare, Best, The Netherlands)
- SENSE:
-
Sensitivity encoding (Philips Healthcare, Best, The Netherlands)
- STIR:
-
Short tau inversion recovery
- THRIVE:
-
T1 high-resolution isotropic volume excitation (Philips Healthcare, Best, The Netherlands)
- UTE:
-
Ultrashort echo time
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Acknowledgements
We would like to address special thanks to our study nurse Olga Ramig. This study would not have been achievable without her ambition.
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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.
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Meier-Schroers, M., Homsi, R., Skowasch, D. et al. Lung cancer screening with MRI: results of the first screening round. J Cancer Res Clin Oncol 144, 117–125 (2018). https://doi.org/10.1007/s00432-017-2521-4
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DOI: https://doi.org/10.1007/s00432-017-2521-4