title: Characterisation of solitary pulmonary lesions combining visual perfusion and quantitative diffusion MR imaging.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of dynamic contrast-enhanced (DCE) magnetic resonance (MR) and diffusion-weighted imaging (DWI) sequences for defining benignity or malignancy of solitary pulmonary lesions (SPL).
  
  
  METHODS
  First, 54 consecutive patients with SPL, clinically staged (CT and PET or integrated PET-CT) as N0M0, were included in this prospective study. An additional 3-Tesla MR examination including DCE and DWI was performed 1 day before the surgical procedure. Histopathology of the surgical specimen served as the standard of reference. Subsequently, this functional method of SPL characterisation was validated with a second cohort of 54 patients.
  
  
  RESULTS
  In the feasibility group, 11 benign and 43 malignant SPL were included. Using the combination of conventional MR sequences with visual interpretation of DCE-MR curves resulted in a sensitivity, specificity and accuracy of 100%, 55% and 91%, respectively. These results can be improved by DWI (with a cut-off value of 1.52 × 10(-3) mm(2)/s for ADChigh) leading to a sensitivity, specificity and accuracy of 98%, 82% and 94%, respectively. In the validation group these results were confirmed.
  
  
  CONCLUSIONS
  Visual DCE-MR-based curve interpretation can be used for initial differentiation of benign from malignant SPL, while additional quantitative DWI-based interpretation can further improve the specificity.
  
  
  CONCLUSIONS
  • Magnetic resonance imaging is increasingly being used to help differentiate lung lesions. • Solitary pulmonary lesions (SPL) are accurately characterised by combining DCE-MRI and DWI. • Visual DCE-MRI assessment facilitates the diagnostic throughput in patients with SPL. • DWI provides additional information in inconclusive DCE-MRI (type B pattern).
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium, johan.coolen@uzleuven.be.
authors.forename: Johan
authors.initials: J
authors.lastname: Coolen
authors.forename: Johan
authors.initials: J
authors.lastname: Vansteenkiste
authors.forename: Frederik
authors.initials: F
authors.lastname: De Keyzer
authors.forename: Herbert
authors.initials: H
authors.lastname: Decaluwé
authors.forename: Walter
authors.initials: W
authors.lastname: De Wever
authors.forename: Christophe
authors.initials: C
authors.lastname: Deroose
authors.forename: Christophe
authors.initials: C
authors.lastname: Dooms
authors.forename: Eric
authors.initials: E
authors.lastname: Verbeken
authors.forename: Paul
authors.initials: P
authors.lastname: De Leyn
authors.forename: Vincent
authors.initials: V
authors.lastname: Vandecaveye
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Raemdonck
authors.forename: Kristiaan
authors.initials: K
authors.lastname: Nackaerts
authors.forename: Steven
authors.initials: S
authors.lastname: Dymarkowski
authors.forename: Johny
authors.initials: J
authors.lastname: Verschakelen
mesh_terms: D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media