Evaluation of lung tumor perfusion by dynamic contrast-enhanced MRI.
The characterization of solid pulmonary lesions with imaging methods remains a diagnostic challenge. The aim of this study was to correlate kinetic parameters of dynamic perfusion magnetic resonance imaging (MRI) with histological tumor classification. Dynamic contrast-enhanced MRI of 31 patients with pulmonary masses (five benign lesions, 26 malignant tumors) was acquired in the tumor areas every 20 s for a mean duration of 124 s. Contrast uptake (CU) was measured by signal analysis in regions of interest (ROIs). The beginning and duration of CU, maximum CU (MCU, % of baseline), maximum contrast upslope (%/s) and the delay to the maximum contrast upslope (s) were calculated. All lesions were classified histologically. The beginning of CU correlated significantly with the MCU delay in all lesions (P=.033). The frequency of a plateau phase was higher in malignant tumors compared to benign lesions (P=.031). Masses with a high MCU showed more frequently a washout of contrast medium after a plateau phase (P=.006) and a higher maximum contrast upslope (P<.001). The MCU delay time was shorter in adenocarcinoma than in squamous cell carcinoma (P=.004). These results indicate that dynamic contrast enhanced MRI might become instrumental in differentiating benign from malignant intrapulmonary tumors and distinguishing adenocarcinoma from squamous cell carcinoma.
Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany. sandra.pauls@uni-ulm.de
Sandra
S
Pauls
Felix M
FM
Mottaghy
Stefan A
SA
Schmidt
Stefan
S
Krüger
Peter
P
Möller
Hans-Jürgen
HJ
Brambs
Arthur
A
Wunderlich
D000230:Adenocarcinoma / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000493:pharmacokinetics*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol