Morphologic characterization of pulmonary nodules with ultrashort TE MRI at 3T

Mark O. Wielpütz, Ho Yun Lee, Hisanobu Koyama, Takeshi Yoshikawa, Shinichiro Seki, Yuji Kishida, Yasuhiro Sakai, Hans Ulrich Kauczor, Kazuro Sugimura, Yoshiharu Ohno

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Abstract

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.

Original languageEnglish
Pages (from-to)1216-1225
Number of pages10
JournalAmerican Journal of Roentgenology
Volume210
Issue number6
DOIs
Publication statusPublished - 06-2018

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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    Wielpütz, M. O., Lee, H. Y., Koyama, H., Yoshikawa, T., Seki, S., Kishida, Y., Sakai, Y., Kauczor, H. U., Sugimura, K., & Ohno, Y. (2018). Morphologic characterization of pulmonary nodules with ultrashort TE MRI at 3T. American Journal of Roentgenology, 210(6), 1216-1225. https://doi.org/10.2214/AJR.17.18961