MR Imaging of Pulmonary Nodules: Detection Rate and Accuracy of Size Estimation in Comparison to Computed Tomography.
OBJECTIVE
The aims of this study were to assess the sensitivity of various magnetic resonance imaging (MRI) sequences for the diagnosis of pulmonary nodules and to estimate the accuracy of MRI for the measurement of lesion size, as compared to computed tomography (CT).


METHODS
Fifty patients with 113 pulmonary nodules diagnosed by CT underwent lung MRI and CT. MRI studies were performed on 1.5T scanner using the following sequences: T2-TSE, T2-SPIR, T2-STIR, T2-HASTE, T1-VIBE, and T1-out-of-phase. CT and MRI data were analyzed independently by two radiologists.


RESULTS
The overall sensitivity of MRI for the detection of pulmonary nodules was 80.5% and according to nodule size: 57.1% for nodules ≤4mm, 75% for nodules >4-6mm, 87.5% for nodules >6-8mm and 100% for nodules >8mm. MRI sequences yielded following sensitivities: 69% (T1-VIBE), 54.9% (T2-SPIR), 48.7% (T2-TSE), 48.7% (T1-out-of-phase), 45.1% (T2-STIR), 25.7% (T2-HASTE), respectively. There was very strong agreement between the maximum diameter of pulmonary nodules measured by CT and MRI (mean difference -0.02 mm; 95% CI -1.6-1.57 mm; Bland-Altman analysis).


CONCLUSIONS
MRI yielded high sensitivity for the detection of pulmonary nodules and enabled accurate assessment of their diameter. Therefore it may be considered an alternative to CT for follow-up of some lung lesions. However, due to significant number of false positive diagnoses, it is not ready to replace CT as a tool for lung nodule detection.
2nd Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland.|Maria Skłodowska-Curie Memorial Cancer Center, Institute of Oncology, Warsaw, Poland.
Andrzej
A
Cieszanowski
2nd Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland.
Antonina
A
Lisowska
Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland.
Marta
M
Dabrowska
Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland.
Piotr
P
Korczynski
2nd Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland.
Malgorzata
M
Zukowska
Department of Toxicology, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland.
Ireneusz P
IP
Grudzinski
2nd Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland.
Ryszard
R
Pacho
2nd Department of Clinical Radiology, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland.
Olgierd
O
Rowinski
Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland.
Rafal
R
Krenke
D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D055613:Multiple Pulmonary Nodules / Q000473:pathology; D003074:Solitary Pulmonary Nodule / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*