The purpose of this study was to describe the use of parallel imaging technique (PAT) using dynamic MRI in lung and tumour mobility during the breathing cycle. 20 patients with stage I non-small cell lung carcinoma were investigated using two dynamic gradient echo sequences with PAT (TrueFISP (fast imaging with steady precession), and fast low angle shot (FLASH). Craniocaudal distance from the apex to the diaphragm of the thorax and tumour mobility during the breathing cycle were measured. Signal-to-noise ratio (SNR) of the tumour was determined. In spite of the different temporal resolutions both trueFISP and FLASH sequence proved to be adequate to continuously measure lung motion and tumour mobility. SNR of the tumour was significantly higher using the trueFISP sequence than FLASH sequence (20.7+/-3.6 vs 5.8+/-2.3, p<0.01). Mobility of the tumour bearing hemithorax was significantly lower compared with the non-tumour bearing hemithorax (p<0.05). Dynamic MRI using PAT allows for continuous quantitative documentation of tumour mobility and lung motion. Because of the higher SNR, trueFISP sequence provides a better delineation of intrapulmonary lesions with a sufficient temporal resolution.
dMRI is capable of monitoring changes in lung motion and volumetry in patients with MPM not detected by global spirometry. Thus, dMRI is proposed for use as a further measure of therapy response.
Purpose: To assess relative forced expiratory volume in one second (FEV1/vital capacity (VC)) in healthy subjects and patients with a lung tumor using dynamic magnetic resonance imaging (dMRI) parameters.
Materials and Methods:In 15 healthy volunteers and 31 patients with a non-small-cell lung carcinoma stage I (NSCLC I), diaphragmatic length change (LE1) and craniocaudal (CC) intrathoracic distance change within one second from maximal inspiration (DE1) were divided by total length change (LE total , DE total ) as a surrogate of spirometric FEV1/VC using a true fast imaging with steady-state precession (trueFISP) sequence (TE/TR ϭ 1.7/37.3 msec, temporal resolution ϭ 3 images/second). Influence of tumor localization was examined.
Results:In healthy volunteers FEV1/VC showed a highly significant correlation with LE1/LE total and DE1/DE total (r Ͼ 0.9, P Ͻ 0.01). In stage IB tumor patients, comparing tumor-bearing with the non-tumor-bearing hemithorax, there was a significant difference in tumors of the middle (LE1/LE total ϭ 0.63 Ϯ 0.05 vs. 0.73 Ϯ 0.04, DE1/DE total ϭ 0.66 Ϯ 0.05 vs. 0.72 Ϯ 0.04; P Ͻ 0.05) and lower (P Ͻ 0.05) lung region. Stage IA tumor patients showed no significant differences with regard to healthy subjects.Conclusion: dMRI is a simple noninvasive method to locally determine LE1/LE total and DE1/DE total as a surrogate of FEV1/VC in volunteers and patients. Tumors of the middle and lower lung regions have a significant influence on these MRI parameters.
The combination of cisplatin with cetuximab and HART is active, well tolerated and merits additional investigation. The recommended weekly dose of cisplatin for phase II studies is 40 mg/m².
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