Dynamic MRI, dynamic multidetector-row computed tomography (MDCT), and coregistered 2-[fluorine-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/CT: comparative study of capability for management of pulmonary nodules.
OBJECTIVE
To compare the nodule management capabilities of dynamic MRI, dynamic multidetector-row computed tomography (MDCT) and coregistered positron emission tomography (PET)/CT.


METHODS
Dynamic MRI, dynamic MDCT, PET, microbacterial, and pathological examinations were administered to 175 consecutive patients with 202 nodules (<30 mm in diameter). The final diagnoses resulted in the classification of 202 nodules into two groups: requiring further intervention and treatment (N = 163) and no further evaluation (N = 39) groups. Maximum relative enhancement and slope of enhancement ratio were calculated as dynamic MR indices. Maximum enhancement, net enhancement, slope of enhancement, and absolute loss of enhancement were calculated as dynamic CT indices. maximum value of standard uptake value (SUV(max)) was measured on coregistered PET/CT. Receiver operating characteristics (ROC) analyses were performed to determine feasible threshold values for nodule management, and results were tested using McNemar's test.


RESULTS
When feasibility threshold values were adopted for nodule management, the specificity (82.1%) and accuracy (93.6%) of the slope of the enhancement ratio were significantly higher than those of dynamic CT indices (P < 0.05) and SUV(max) (P < 0.05).


CONCLUSIONS
Dynamic MRI can play a more specific and/or accurate role for nodule management as compared with dynamic MDCT and coregistered PET/CT.
Ohno
Yoshiharu
Y
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan. yosirad@kobe-u.ac.jp
Koyama
Hisanobu
H
Takenaka
Daisuke
D
Nogami
Munenobu
M
Maniwa
Yoshimasa
Y
Nishimura
Yoshihiro
Y
Ohbayashi
Chiho
C
Sugimura
Kazuro
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis; D002277:Carcinoma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006222:Hamartoma / Q000150:complications; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011014:Pneumonia / Q000175:diagnosis; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18