TY - JOUR
T1 - Morphologic characterization of pulmonary nodules with ultrashort TE MRI at 3T
AU - Wielpütz, Mark O.
AU - Lee, Ho Yun
AU - Koyama, Hisanobu
AU - Yoshikawa, Takeshi
AU - Seki, Shinichiro
AU - Kishida, Yuji
AU - Sakai, Yasuhiro
AU - Kauczor, Hans Ulrich
AU - Sugimura, Kazuro
AU - Ohno, Yoshiharu
N1 - Funding Information:
Supported by Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; no. 15K09923) and by Toshiba Medical Systems Corporation and Toshiba Medical Research Institute USA (Toshiba did not have any influence on the statistical evaluation, data interpretation, or article preparation). M. O. Wielpütz received support from the German Center for Lung Research through a grant from the Federal Ministry of Education and Research Germany and through a grant from the University of Heidelberg. The contract grant sponsor for Y. Ohno is Toshiba Medical Systems Corporation.
PY - 2018/6
Y1 - 2018/6
N2 - OBJECTIVE. Ultrashort TE (UTE) MRI has been shown to deliver high-resolution images comparable to CT images. Here we evaluate the potential of UTE-MRI for precise lung nodule characterization. SUBJECTS AND METHODS. Fifty-one patients (mean [± SD] age, 68.7 ± 10.8 years) with 119 nodules or masses (mean size, 17.4 ± 16.3 mm; range, 4–88 mm) prospectively underwent CT (1-mm slice thickness) and UTE-MRI (TE, 192 µs; 1 mm 3 resolution). Two radiologists assessed nodule dimensions and morphologic features (i.e., attenuation, margins, and internal lucencies), in consensus for CT and in a blinded fashion for UTE-MRI. Sensitivity, specificity, and kappa statistics were calculated in reference to CT. RESULTS. Readers 1 and 2 underestimated the nodules’ long axial diameter with UTE-MRI by 1.2 ± 3.4 and 2.1 ± 4.2 mm, respectively (p < 0.001). The sensitivity and specificity of UTE-MRI for subsolid attenuation were 95.9% and 70.3%, respectively, for reader 1 and 97.1% and 71.4%, respectively, for reader 2 (? = 0.71 and 0.68). With regard to margin characteristics, for lobulation, sensitivity was 70.6% and 54.9%, and specificity was 93.2% and 96.3% for readers 1 and 2, respectively; for spiculation, sensitivity was 61.5% and 48.0%, and specificity was 95.2% and 95.0%; and for pleural tags, sensitivity was 87.0% and 73.3%, and specificity was 93.8% and 95.0%. Finally, for internal lucencies, sensitivity was 72.7% and 61.3%, and specificity was 96.1% and 97.3% for readers 1 and 2, respectively (? = 0.64–0.81 for reader 1 and 0.48–0.72 for reader 2). Interreader agreement for attenuation, margin characteristics, and lucencies was substantial to almost perfect with few exceptions (? = 0.51–0.90). CONCLUSION. UTE-MRI systematically underestimated dimension measurements by approximately 1–2 mm but otherwise showed high diagnostic properties and interreader agreement, yet unprecedented by MRI, for nodule morphologic assessment.
AB - OBJECTIVE. Ultrashort TE (UTE) MRI has been shown to deliver high-resolution images comparable to CT images. Here we evaluate the potential of UTE-MRI for precise lung nodule characterization. SUBJECTS AND METHODS. Fifty-one patients (mean [± SD] age, 68.7 ± 10.8 years) with 119 nodules or masses (mean size, 17.4 ± 16.3 mm; range, 4–88 mm) prospectively underwent CT (1-mm slice thickness) and UTE-MRI (TE, 192 µs; 1 mm 3 resolution). Two radiologists assessed nodule dimensions and morphologic features (i.e., attenuation, margins, and internal lucencies), in consensus for CT and in a blinded fashion for UTE-MRI. Sensitivity, specificity, and kappa statistics were calculated in reference to CT. RESULTS. Readers 1 and 2 underestimated the nodules’ long axial diameter with UTE-MRI by 1.2 ± 3.4 and 2.1 ± 4.2 mm, respectively (p < 0.001). The sensitivity and specificity of UTE-MRI for subsolid attenuation were 95.9% and 70.3%, respectively, for reader 1 and 97.1% and 71.4%, respectively, for reader 2 (? = 0.71 and 0.68). With regard to margin characteristics, for lobulation, sensitivity was 70.6% and 54.9%, and specificity was 93.2% and 96.3% for readers 1 and 2, respectively; for spiculation, sensitivity was 61.5% and 48.0%, and specificity was 95.2% and 95.0%; and for pleural tags, sensitivity was 87.0% and 73.3%, and specificity was 93.8% and 95.0%. Finally, for internal lucencies, sensitivity was 72.7% and 61.3%, and specificity was 96.1% and 97.3% for readers 1 and 2, respectively (? = 0.64–0.81 for reader 1 and 0.48–0.72 for reader 2). Interreader agreement for attenuation, margin characteristics, and lucencies was substantial to almost perfect with few exceptions (? = 0.51–0.90). CONCLUSION. UTE-MRI systematically underestimated dimension measurements by approximately 1–2 mm but otherwise showed high diagnostic properties and interreader agreement, yet unprecedented by MRI, for nodule morphologic assessment.
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U2 - 10.2214/AJR.17.18961
DO - 10.2214/AJR.17.18961
M3 - Article
C2 - 29547055
AN - SCOPUS:85047730840
VL - 210
SP - 1216
EP - 1225
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
SN - 0361-803X
IS - 6
ER -