title: Added value of DCE-MRI in the management of cystic-cavitary lung lesions.
abstract: OBJECTIVE
  We evaluated the added value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) to CT in the evaluation of cystic-cavitary lung lesions. We aimed to compare morphological parameters, including wall thickness and inner wall irregularity, and to determine whether DCE-MRI with morphological and dynamic parameters was useful in indeterminate lesions. We also aimed to investigate the added value of DCE-MRI in terms of whether to biopsy, and if so the site of biopsy.
  
  
  METHODS
  This prospective study included 39 consecutive patients with cystic and/or cavitary lung lesions detected by CT who then underwent additional DCE-MRI. After initial evaluation, the lesions were classified as benign, indeterminate or malignant and the findings of CT and DCE-MRI compared with each other by considering the final diagnosis that was determined by histopathological findings and clinical evaluation and follow up.
  
  
  RESULTS
  The mean values for wall thickness obtained by DCE-MRI were lower and the range of wall thickness for indeterminate lesions was narrower than those obtained by CT (5.50-11.50 mm and 5.75-13.50 mm for DCE-MRI and CT), and inner wall irregularity on DCE-MRI was more sensitive in malignant lesions. Also, DCE-MRI obviated biopsy in three benign patients and changed the biopsy site in two patients.
  
  
  CONCLUSIONS
  Our study suggests that DCE-MRI is helpful in indeterminate cystic-cavitary lung lesions, with morphological and dynamic features. It narrowed the range of wall thickness used for indeterminate lesions, was more sensitive than CT in determining malignant inner wall irregularity, and was also useful in determining the need for and appropriate site of biopsy. See article, page 576.
authors.affiliation: Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Karaman
authors.affiliation: Department of Pulmonary Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Araz
authors.affiliation: Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Irmak
authors.initials: I
authors.lastname: Durur-Subasi
authors.affiliation: Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Alper
authors.affiliation: Department of Chest Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Subasi
authors.affiliation: Department of Radiology, Istanbul Medipol University, Istanbul, Turkey.
authors.forename: Afak D
authors.initials: AD
authors.lastname: Karakaya
authors.affiliation: Department of Pulmonary Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Akgun
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D000066491:Clinical Decision-Making; D003287:Contrast Media; D003560:Cysts / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: biopsy; computerized tomography; cystic-cavitary lung lesion; dynamic contrast enhanced magnetic resonance imaging