Monitoring of lung motion in patients with malignant pleural mesothelioma using two-dimensional and three-dimensional dynamic magnetic resonance imaging: comparison with spirometry.
OBJECTIVE
To monitor lung motion in patients with malignant pleural mesothelioma (MPM) before and after chemotherapy (CHT) using 2-dimensional (2D) and 3-dimensional (3D) dynamic MRI (dMRI) in comparison with spirometry.


METHODS
Twenty-two patients with MPM were examined before CHT, as well as after 3 and 6 CHT cycles (3 months and 6 months) using 2D dMRI (trueFISP; 3 images/s) and 3D dMRI (FLASH 3D, 1 slab (52 slices)/s) using parallel imaging in combination with view-sharing technique. Maximum craniocaudal lung dimensions (2D) and lung volumes (3D) were monitored, separated into the tumor-bearing and nontumor-bearing hemithorax. Vital capacity (VC) was measured for comparison using spirometry.


RESULTS
Using 2D technique, there was a significant difference between the tumor-bearing and the nontumor-bearing hemithorax before CHT (P < 0.01) and after 3 CHT cycles (P < 0.05), whereas difference was not significant in the second control. In the tumor-bearing hemithorax, mobility increased significantly from the status before versus after 3 CHT cycles (4.1 +/- 1.1 cm vs. 4.8 +/- 1.4 cm, P < 0.05). Using 3D technique, at maximum inspiration, the volume of the tumor-bearing hemithorax was 0.6 +/- 0.4 L and of the nontumor-bearing hemithorax 1.25 +/- 0.4 L before CHT. In the follow-up exams, these volumes changed to 1.05 +/- 0.4 L (P < 0.05) and 1.4 +/- 0.5 L, respectively. Using spirometry, there was no significant change in VC (1.9 +/- 0.4 L vs. 2.2 +/- 0.7 L vs. 2.2 +/- 0.9 L).


CONCLUSIONS
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.
Plathow
Christian
C
Department of Diagnostic Radiology, Eberhard-Karls University, Tuebingen, Germany. christian.plathow@med.uni-tuebingen.de
Klopp
Michael
M
Schoebinger
Max
M
Thieke
Christian
C
Fink
Christian
C
Puderbach
Michael
M
Ley
Sebastian
S
Weber
Marc-Andre
MA
Sandner
Alexandra
A
Claussen
Claus D
CD
Herth
Felix
F
Tuengerthal
Siegfried
S
Meinzer
Hans-Peter
HP
Kauczor
Hans-Ulrich
HU
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000473:pathology*; D008176:Lung Volume Measurements; D008279:Magnetic Resonance Imaging; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy / Q000503:physiopathology*; D008875:Middle Aged; D009068:Movement; D010997:Pleural Neoplasms / Q000188:drug therapy / Q000503:physiopathology*; D013147:Spirometry; D014797:Vital Capacity
D000970:Antineoplastic Agents