Solitary pulmonary nodules: MR evaluation of enhancement patterns with contrast-enhanced dynamic snapshot gradient-echo imaging.

Gückel, C; Schnabel, K; Deimling, M.; Steinbrich, W.

doi:10.1148/radiology.200.3.8756914

Cited by 88 publications

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“…Our study techniques involved a quantitative method based on a whole nodule perfusion measurement and rapid dynamic acquisitions focused on the first pass of contrast material, as this early phase seemed to be very important to the differentiation of malignant from benign SPNs [2,4,10]. By using a 64-dectector row CT scanner, a 40 mm volume tissue coverage along the z-axis was available, which encompassing the entire nodule.…”

Section: Discussionmentioning

confidence: 99%

First-pass perfusion imaging of solitary pulmonary nodules with 64-detector row CT: comparison of perfusion parameters of malignant and benign lesions

Zg²,

Tw³

et al. 2010

BJR

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ABSTRACT. The purpose of this study was to determine the usefulness of first-pass whole nodule perfusion imaging in the differentiation of benign and malignant solitary pulmonary nodules (SPNs). 77 patients with non-calcified SPNs (46 malignant, 22 benign and 9 active inflammatory) underwent first-pass perfusion imaging with a 64-detector row CT scanner. Perfusion, peak enhancement intensity (PEI), time to peak (TTP) and blood volume (BV) were measured and statistically compared among different groups. Mean perfusion, PEI and BV for benign SPNs were significantly lower than those for malignant nodules (p,0.05) and active infections (p,0.05), but the differences were not statistically significant between malignant tumours and active infections (p.0.05). Receiver operating characteristic (ROC) curve analysis showed that SPNs with perfusion greater than 30.6 ml min -1 ml -1 , PEI higher than 23.3 HU or BV larger than 12.2 ml per 100 g were more likely to be malignant. In conclusion, first-pass perfusion imaging with 64-detector row CT is a feasible way of assessing whole nodule perfusion and helpful in differentiating benign from malignant SPNs. The differentiation of solitary pulmonary nodules (SPNs) as benign or malignant remains a diagnostic challenge for thoracic radiology. During the past decade, promising results for more specific differentiation of malignant and benign nodules using dynamic contrast material-enhanced CT have been reported [1][2][3][4][5][6]. Techniques in these studies rely on single-level acquisition with long time intervals, which were considered to be problematic for quantitative assessment of whole tumour perfusion because the blood flow within tumours is spatially and temporally heterogeneous [7,8]. Nevertheless, current technological advances in multidetector row CT (MDCT), specifically sequential volume acquisition and data processing, allow for more accurate evaluation of tissue haemodynamics than that attainable with previous CT techniques. A recent study on MDCT perfusion techniques assessed whole tumour perfusion with the volume coverage of 40 mm in patients with non-small-cell lung carcinoma and achieved good measurement reproducibility [8].To the best of our knowledge, no data exist on the application of first-pass perfusion CT for the differentiation of benign and malignant SPNs [1][2][3][4][5][6]8]. The purpose of our study, therefore, was to determine the utility of first-pass whole nodule perfusion imaging in the differentiation of benign and malignant SPNs. Methods and materialsBetween August 2006 and May 2007, a total of 93 patients with a newly detected SPN at cross-sectional imaging or conventional radiography (61 men and 32 women; age range 22-79 years; mean age 54.9 years) were recruited prospectively according to the following criteria: presence of SPN 30 mm or less in diameter, without evidence of calcification or fat attenuation, absence of contraindication to the administration of contrast medium and probable ability to co-operate with the procedure. Of these, 77 p...

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Section: Discussionmentioning

confidence: 99%

First-pass perfusion imaging of solitary pulmonary nodules with 64-detector row CT: comparison of perfusion parameters of malignant and benign lesions

Zg²,

Tw³

et al. 2010

BJR

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“…2 and 3). It has therefore been suggested that enhancement patterns or blood supply evaluated with dynamic contrast-enhanced MR imaging may be helpful for diagnosis and management of pulmonary nodules (Kono et al 1993(Kono et al , 2007Kusumoto et al 1994;Hittmair et al 1995;Gückel et al 1996;Fujimoto et al 2003;Ohno et al 2002Ohno et al , 2004aSchaefer et al 2004Schaefer et al , 2006Donmez et al 2007). However, it may be possible to diagnose several histological types of pulmonary nodules, such as bronchocele, tuberculoma, mucinous bronchoalveolar carcinoma (BAC), hamartoma, and aspergilloma, on pre-or post-contrastenhanced T1-weighted images and T2-weighted image according to their specific MR findings.…”

Section: Characterization and Management Of Pulmonary Nodules Or Massmentioning

confidence: 99%

“…These curves represent first transit and/or recirculation and washout of contrast media in irregularly thickened cavity wall as, respectively, low and high signal intensities in the left lower lobe. Post-contrast black-blood T1-weighted turbo SE (e) image shows wellenhanced cavity wall corresponding to lung cancer 5 min or more with repeated breath holding (Kono et al 1993(Kono et al , 2007Kusumoto et al 1994;Hittmair et al 1995;Gückel et al 1996;Ohno et al 2002Ohno et al , 2004aFujimoto et al 2003;Schaefer et al 2004Schaefer et al , 2006Donmez et al 2007). Taking into account the inherent inhomogeneous composition of many intraindividual lung cancers and even within benign lesions such as central necrosis, only a dynamic show intracavitary lesion as, respectively, low and very low signal intensities in the left upper lobe.…”

Section: Dynamic Contrast-enhanced Mr Imaging Of Pulmonary Nodulesmentioning

confidence: 99%

“…This circumstance has not been accounted for in the usual models for quantification of tissue perfusion so far. Although there are various dynamic MR techniques, reported sensitivities range from 94 to 100%, specificities from 70 to 96%, and accuracies of more than 94% (Kono et al 1993(Kono et al , 2007Patz et al 1993;Kusumoto et al 1994;Hittmair et al 1995;Gückel et al 1996;Ohno et al 2002Ohno et al , 2004aFujimoto et al 2003;Schaefer et al 2004Schaefer et al , 2006Donmez et al 2007). These specificities and accuracies for dynamic MR imaging are superior to those reported for dynamic CT and almost equal to or superior to those for FDG-PET or PET/CT (Swensen et al 1992(Swensen et al , 1996(Swensen et al , 2000Dewan et al 1993;Kono et al 1993;Kusumoto et al 1994;Hittmair et al 1995;Yamashita et al 1995;Bury et al 1996;Gückel et al 1996;Zhang and Kono 1997;Ohno et al 2002Ohno et al , 2004aFujimoto et al 2003;Herder et al 2004;Schaefer et al 2004Schaefer et al , 2006Yi et al 2004Yi et al , 2006Jeong et al 2005;Joshi et al 2005;Mori et al 2005;Bryant and Cerfolio 2006;Christensen et al 2006;Donmez et al 2007;…”

Section: Dynamic Contrast-enhanced Mr Imaging Of Pulmonary Nodulesmentioning

confidence: 99%

“…In the last a few decades, the diagnostic performance of these dynamic MR techniques for distinguishing malignant from benign nodules has been reported as comprising sensitivity ranging from 94 to 100%, specificity from 70 to 96%, and accuracy of more than 94% (Gückel et al 1996;Ohno et al 2002Ohno et al , 2004aOhno et al , 2008aOhno et al , 2014Fujimoto et al 2003;Schaefer et al 2004;Kono et al 2007;Cronin et al 2008). In addition, a meta-analysis found that there were no significant differences in diagnostic performance among dynamic CE-CT, dynamic CE-MR imaging, FDG-PET, and single photon emission tomography (SPECT) (Cronin et al 2008), although dynamic MR imaging with the 3D GRE sequence and ultrashort TE proved its superior diagnostic performance in a direct and prospective comparison study of dynamic CE-CT and co-registered FDG-PET/CT (Ohno et al 2008a).…”

Section: Dynamic Contrast-enhanced Mr Imaging Of Pulmonary Nodulesmentioning

confidence: 99%

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Since the publication of the Radiologic Diagnostic Oncology Group Report (RDOG) in 1991, the clinical application of pulmonary magnetic resonance (MR) imaging to patients with lung cancer has been limited. MDCT has been much more widely available for staging of lung cancer in clinical situations. Traditionally, FDG-PET or PET/CT is the only modality that reveals biological glucose metabolism of lung cancer, and ventilation and/or perfusion scintigraphy is the only modality that demonstrates pulmonary function. However, recent advances of MR systems and utilization of contrast media make it possible to overcome the limitation of chest MR imaging. Therefore, in the last years, several investigators have demonstrated the significant comprehensive potential of MR imaging to substitute for MDCT and nuclear medicine examinations in lung cancer staging. Currently, MR imaging in lung cancer patients can be applied for (1) detection of pulmonary nodules, (2) characterization of solitary pulmonary nodules, and (3) assessment of TNM classification in routine clinical practice. We believe that further basic studies, as well as clinical applications of newer MR techniques, will play an important role in the future management of patients with lung cancer including MRI.

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Breath-hold 3D gradient-echo MR imaging of the lung parenchyma: Evaluation of reproducibility of image quality in normals and preliminary observations in patients with disease

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Wilber

et al. 2000

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Solitary pulmonary nodules: MR evaluation of enhancement patterns with contrast-enhanced dynamic snapshot gradient-echo imaging.

Abstract: Dynamic contrast-enhanced MR measurements of tumor enhancement can provide additional information about the nature of SPNs.

Cited by 88 publications

References 0 publications

First-pass perfusion imaging of solitary pulmonary nodules with 64-detector row CT: comparison of perfusion parameters of malignant and benign lesions

First-pass perfusion imaging of solitary pulmonary nodules with 64-detector row CT: comparison of perfusion parameters of malignant and benign lesions

Lung Cancer

Breath-hold 3D gradient-echo MR imaging of the lung parenchyma: Evaluation of reproducibility of image quality in normals and preliminary observations in patients with disease

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