Determination of the optimal MRI sequence for the detection of malignant lung nodules.
OBJECTIVE
For staging, follow-up and even screening (www.screening.info) an "all-in-one" imaging examination is desirable. In the concept of whole body MRI, lung imaging prevails as the weakest link. The purpose of our study was to determine the optimal MRI sequences for the detection of malignant lung nodules.


METHODS
On the basis of 6 lung cancer, 46 metastases and one tuberculoma in 13 patients eight MRI sequences--HASTE, IR-HASTE, fat saturated TrueFISP, STIR, VIBEipat = 2, and contrast-enhanced (CE) VIBE (with ipat = 2, 0, 4) performed with parallel imaging and 12 matrix coil elements--were compared in terms of contrast-to-noise ratio (CNR) and quality in the visualization of the lung nodules using multidetector CT as standard of reference. The parameters of the sequences were pragmatically selected to minimize the imaging time to allow for imaging the entire lung within one breathold interval.


RESULTS
The STIR sequence was found to be the best for detecting malignant lung nodules (p<0.01) followed by the FS TrueFISP, CE VIBE subsetipat = 0, CE VIBE subsetipat = 2, IR-HASTE, HASTE, CE VIBE subsetipat = 4, and VIBE. The STIR sequence visualized malignant nodules down to 2 mm in size and did not display the 19 mm tuberculoma.


CONCLUSIONS
The STIR sequence should be included in future studies investigating if MRI can compete with CT in the early identification (detection and classification) of malignant lung nodules.
Luboldt
W
W
Department of Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany. luboldt@screening.info
Wetter
A
A
Eichler
K
K
Vogl
T J
TJ
Wagner
T O F
TO
Seemann
M D
MD
D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary; D003110:Colonic Neoplasms / Q000473:pathology / Q000556:secondary; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D010307:Parotid Neoplasms / Q000473:pathology / Q000556:secondary; D010865:Pilot Projects; D013964:Thyroid Neoplasms / Q000473:pathology / Q000556:secondary; D014057:Tomography, X-Ray Computed / Q000379:methods; D014375:Tuberculoma / Q000473:pathology