Dynamic MRI, dynamic multidetector-row computed tomography (MDCT), and coregistered 2-[fluorine-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/CT: Comparative study of capability for management of pulmonary nodules

Purpose: To compare the nodule management capabilities of dynamic MRI, dynamic multidetector-row computed tomography (MDCT) and coregistered positron emission tomography (PET)/CT. Materials and Methods: Dynamic MRI, dynamic MDCT, PET, microbacterial, and pathological examinations were administered to 175 consecutive patients with 202 nodules (<30 mm in diameter). The final diagnoses resulted in the classification of 202 nodules into two groups: requiring further intervention and treatment (N = 163) and no further evaluation (N = 39) groups. Maximum relative enhancement and slope of enhancement ratio were calculated as dynamic MR indices. Maximum enhancement, net enhancement, slope of enhancement, and absolute loss of enhancement were calculated as dynamic CT indices, maximum value of standard uptake value (SUV_max) was measured on coregistered PET/CT. Receiver operating characteristics (ROC) analyses were performed to determine feasible threshold values for nodule management, and results were tested using McNemar's test. Results: When feasibility threshold values were adopted for nodule management, the specificity (82.1%) and accuracy (93.6%) of the slope of the enhancement ratio were significantly higher than those of dynamic CT indices (P < 0.05) and SUV _max (P < 0.05). Conclusion: Dynamic MRI can play a more specific and/or accurate role for nodule management as compared with dynamic MDCT and coregistered PET/CT.