Gregor Sommer1, Jan Tremper2, Marcel Koenigkam-Santos3, Stefan Delorme4, Nikolaus Becker5, Jürgen Biederer6, Hans-Ulrich Kauczor7, Claus Peter Heussel8, Heinz-Peter Schlemmer9, Michael Puderbach10. 1. Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland. Electronic address: gregor.sommer@usb.ch. 2. Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany. Electronic address: j.tremper@dkfz.de. 3. Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg, Germany; Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto - University of Sao Paulo, Av. Bandeirantes 3900, Campus Universitario Monte Alegre, 14048 900 Ribeirao Preto, SP, Brazil. Electronic address: marcelk46@yahoo.com.br. 4. Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany. Electronic address: s.delorme@dkfz.de. 5. Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany. Electronic address: n.becker@dkfz.de. 6. Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: juergen.biederer@uni-heidelberg.de. 7. Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: hu.kauczor@med.uni-heidelberg.de. 8. Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg, Germany. Electronic address: heussel@uni-heidelberg.de. 9. Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany. Electronic address: h.schlemmer@dkfz.de. 10. Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg, Germany. Electronic address: m.puderbach@gmail.com.
Abstract
OBJECTIVE: To investigate the potential of MRI for lung nodule detection in a high-risk population in comparison to low-dose CT. METHODS: 49 participants (31 men, 18 women, 51-71 years) of the German Lung Cancer Screening and Intervention Trial (LUSI) with a cancer-suspicious lung lesion in CT were examined with non-contrast-enhanced MRI of the lung at 1.5 T. Data were pseudonymized and presented at random order together with 30 datasets (23 in men, 7 in women, 18-64 years) from healthy volunteers. Two radiologists read the data for the presence of nodules. Sensitivity and specificity were calculated. Gold standard was either histology or long-term follow-up. Contrast-to-Noise-Ratio (CNR) was measured for all detected lesions in all MRI sequences. RESULTS: Average maximum diameter of the lesions was 15 mm. Overall sensitivity and specificity of MRI were 48% (26/54) and 88% (29/33) compared to low-dose CT. Sensitivity of MRI was significantly higher for malignant nodules (78% (12.5/16)) than for benign ones (36% (13.5/38); P=0.007). There was no statistically significant difference in sensitivity between nodules (benign and malignant) larger or smaller than 10 mm (P=0.7). Inter observer agreement was 84% (κ=0.65). Lesion-to-background CNR of T2-weighted single-shot turbo-spin-echo was significantly higher for malignant nodules (89±27) than for benign ones (56±23; P=0.002). CONCLUSION: The sensitivity of MRI for detection of malignant pulmonary nodules in a high-risk population is 78%. Due to its inherent soft tissue contrast, MRI is more sensitive to malignant nodules than to benign ones. MRI may therefore represent a useful test for early detection of lung cancer.
OBJECTIVE: To investigate the potential of MRI for lung nodule detection in a high-risk population in comparison to low-dose CT. METHODS: 49 participants (31 men, 18 women, 51-71 years) of the German Lung Cancer Screening and Intervention Trial (LUSI) with a cancer-suspicious lung lesion in CT were examined with non-contrast-enhanced MRI of the lung at 1.5 T. Data were pseudonymized and presented at random order together with 30 datasets (23 in men, 7 in women, 18-64 years) from healthy volunteers. Two radiologists read the data for the presence of nodules. Sensitivity and specificity were calculated. Gold standard was either histology or long-term follow-up. Contrast-to-Noise-Ratio (CNR) was measured for all detected lesions in all MRI sequences. RESULTS: Average maximum diameter of the lesions was 15 mm. Overall sensitivity and specificity of MRI were 48% (26/54) and 88% (29/33) compared to low-dose CT. Sensitivity of MRI was significantly higher for malignant nodules (78% (12.5/16)) than for benign ones (36% (13.5/38); P=0.007). There was no statistically significant difference in sensitivity between nodules (benign and malignant) larger or smaller than 10 mm (P=0.7). Inter observer agreement was 84% (κ=0.65). Lesion-to-background CNR of T2-weighted single-shot turbo-spin-echo was significantly higher for malignant nodules (89±27) than for benign ones (56±23; P=0.002). CONCLUSION: The sensitivity of MRI for detection of malignant pulmonary nodules in a high-risk population is 78%. Due to its inherent soft tissue contrast, MRI is more sensitive to malignant nodules than to benign ones. MRI may therefore represent a useful test for early detection of lung cancer.
Authors: G Wilson Miller; John P Mugler; Rui C Sá; Talissa A Altes; G Kim Prisk; Susan R Hopkins Journal: NMR Biomed Date: 2014-07-02 Impact factor: 4.044
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Authors: Bertram J Jobst; Mark O Wielpütz; Simon M F Triphan; Angela Anjorin; Julia Ley-Zaporozhan; Hans-Ulrich Kauczor; Jürgen Biederer; Sebastian Ley; Oliver Sedlaczek Journal: PLoS One Date: 2015-09-01 Impact factor: 3.240
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