title: Performance of magnetic resonance imaging in pulmonary fungal disease compared to high-resolution computed tomography.
abstract: To evaluate the performance of magnetic resonance imaging (MRI) compared to computed tomography (CT) in patients diagnosed with pulmonary mycosis. We prospectively included 21 patients diagnosed with pulmonary mycosis between January 2013 and October 2014. Inclusion criteria were presence of respiratory symptoms, histopathological diagnosis of mycosis and absence of mycosis treatment. Reviewers identified one predominant imaging pattern per patient: nodular, reticular or airspace pattern. Afterwards, all CT findings were analysed separately per lobe and compared to MRI. Nodular pattern was the most common found (CT: 76.20%; MRI: 80.96%), followed by airspace pattern (CT and MRI: 9.52%) and reticular (CT: 9.52%; MRI: 4.76%). Compared to CT, MRI performance varied according to radiological finding and pulmonary region. For nodules, MRI presented high sensitivity (100% [95% CI: 93.52-100]) and specificity (100% [95% CI: 92.00-100]). For bronchiectasis and septal thickening, there were poorer positive predictive values (33.33% [95% CI: 1.77-87.47]; and 83.33% [95% CI: 50.88-97.06] respectively). As specificity and negative predictive value had superior results than sensitivity and positive predictive value, rather than for diagnosis of this condition, MRI might be more considered for the follow-up of patients with pulmonary mycosis, an alternative to multiple radiation exposures with CT follow-up.
authors.affiliation: LABIMED - Medical Imaging Research Lab, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Ana
authors.initials: A
authors.lastname: Sartori
authors.affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Arthur
authors.initials: A
authors.lastname: Souza
authors.affiliation: LABIMED - Medical Imaging Research Lab, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.|Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
authors.forename: Matheus
authors.identifier: http://orcid.org/0000-0001-7851-5125
authors.initials: M
authors.lastname: Zanon
authors.affiliation: Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, UK.
authors.forename: Klaus
authors.initials: K
authors.lastname: Irion
authors.affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Marchiori
authors.affiliation: LABIMED - Medical Imaging Research Lab, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Watte
authors.affiliation: LABIMED - Medical Imaging Research Lab, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.|Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hochhegger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: computed tomography; diffusion-weighted imaging; magnetic resonance imaging; mycosis; pulmonary fungal disease