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