Differentiation between malignant and benign solitary pulmonary nodules with proton density weighted and ECG-gated magnetic resonance imaging.
OBJECTIVE
To estimate performance of MRI for differentiating malignant from benign solitary pulmonary nodules (SPN) using morphological characteristics.


METHODS
MRI in 46 patients with SPN (mean diameter: 19 mm) was carried out on 1.0 Tesla scanner using ECG-gated, gradient echo sequence. Morphological signs of SPN were determined and compared with previously performed helical-CT, where final diagnosis served as reference with 52% frequency of malignancy. Furthermore, three observers evaluated all images.


RESULTS
Significant differences between the two groups were found for nodules shape, margin, inhomogeneity and the vessel-sign in MRI, nodules shape, margin, the vessel-sign, and presence of spicules in CT. Using these signs, AUC were 0.746 for MRI and 0.765 for CT. The mean sensitivity, specificity, and accuracy of observers for MRI/CT were 89%/95%, 42%/41%, 66%/68%, respectively.


CONCLUSIONS
Despite discrepancies in morphologic appearance, no significant difference of accuracy between MRI and CT was determined. Further investigations are necessary to demonstrate the clinical use in combination with functional parameters, establishing MRI as a comprehensive diagnostic modality for SPN.
Schaefer
Juergen F
JF
Department of Diagnostic Radiology, University of Tuebingen, Hoppe- Seyler-Str. 3, 72076 Tuebingen, Germany. juergen.schaefer@med.uni-tuebingen.de
Vollmar
J
J
Wiskirchen
J
J
Erdtmann
B
B
V Renteln
D
D
Vonthein
R
R
Schick
F
F
Claussen
C D
CD
Seemann
M D
MD
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000000981:diagnostic imaging; D002277:Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006222:Hamartoma / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011522:Protons; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014375:Tuberculoma / Q000175:diagnosis / Q000000981:diagnostic imaging
D011522:Protons