Science and Research

Morphologic Characterization of Pulmonary Nodules With Ultrashort TE MRI at 3T

OBJECTIVE: Ultrashort TE (UTE) MRI has been shown to deliver high-resolution images comparable to CT images. Here we evaluate the potential of UTE-MRI for precise lung nodule characterization. SUBJECTS AND METHODS: Fifty-one patients (mean [+/- SD] age, 68.7 +/- 10.8 years) with 119 nodules or masses (mean size, 17.4 +/- 16.3 mm; range, 4-88 mm) prospectively underwent CT (1-mm slice thickness) and UTE-MRI (TE, 192 mus; 1 mm(3) resolution). Two radiologists assessed nodule dimensions and morphologic features (i.e., attenuation, margins, and internal lucencies), in consensus for CT and in a blinded fashion for UTE-MRI. Sensitivity, specificity, and kappa statistics were calculated in reference to CT. RESULTS: Readers 1 and 2 underestimated the nodules' long axial diameter with UTEMRI by 1.2 +/- 3.4 and 2.1 +/- 4.2 mm, respectively (p < 0.001). The sensitivity and specificity of UTE-MRI for subsolid attenuation were 95.9% and 70.3%, respectively, for reader 1 and 97.1% and 71.4%, respectively, for reader 2 (kappa = 0.71 and 0.68). With regard to margin characteristics, for lobulation, sensitivity was 70.6% and 54.9%, and specificity was 93.2% and 96.3% for readers 1 and 2, respectively; for spiculation, sensitivity was 61.5% and 48.0%, and specificity was 95.2% and 95.0%; and for pleural tags, sensitivity was 87.0% and 73.3%, and specificity was 93.8% and 95.0%. Finally, for internal lucencies, sensitivity was 72.7% and 61.3%, and specificity was 96.1% and 97.3% for readers 1 and 2, respectively (kappa = 0.64-0.81 for reader 1 and 0.48-0.72 for reader 2). Interreader agreement for attenuation, margin characteristics, and lucencies was substantial to almost perfect with few exceptions (kappa = 0.51-0.90). CONCLUSION: UTE-MRI systematically underestimated dimension measurements by approximately 1-2 mm but otherwise showed high diagnostic properties and interreader agreement, yet unprecedented by MRI, for nodule morphologic assessment.
  • Wielputz, M. O.
  • Lee, H. Y.
  • Koyama, H.
  • Yoshikawa, T.
  • Seki, S.
  • Kishida, Y.
  • Sakai, Y.
  • Kauczor, H. U.
  • Sugimura, K.
  • Ohno, Y.

Keywords

  • Aged
  • *Dimensional Measurement Accuracy
  • Female
  • Humans
  • Lung Neoplasms/*diagnostic imaging/pathology
  • Magnetic Resonance Imaging/*methods
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Solitary Pulmonary Nodule/*diagnostic imaging/pathology
  • Tomography, X-Ray Computed
  • Mdct
  • Mri
  • dimensional measurement accuracy
  • lung neoplasms
  • solitary pulmonary nodule
Publication details
DOI: 10.2214/AJR.17.18961
Journal: AJR. American journal of roentgenology
Pages: 1216-1225 
Number: 6
Work Type: Original
Location: TLRC
Disease Area: PLI
Partner / Member: RKU
Access-Number: 29547055
See publication on PubMed

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