Diagnosing Lung Nodules on Oncologic MR/PET Imaging: Comparison of Fast T1-Weighted Sequences and Influence of Image Acquisition in Inspiration and Expiration Breath-Hold.
10.3348/kjr.2016.17.5.684
- Author:
Nina F SCHWENZER
1
;
Ferdinand SEITH
;
Sergios GATIDIS
;
Cornelia BRENDLE
;
Holger SCHMIDT
;
Christina A PFANNENBERG
;
Christian LAFOUGÈRE
;
Konstantin NIKOLAOU
;
Christina SCHRAML
Author Information
1. Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076, Germany. christina.schraml@med.uni-tuebingen.de
- Publication Type:Original Article
- Keywords:
PET/MR;
PET/MRI;
MR/PET;
Lung;
Pulmonary nodule;
Inspiration;
Expiration
- MeSH:
Ethics Committees, Research;
Humans;
Lung*;
Positron-Emission Tomography and Computed Tomography
- From:Korean Journal of Radiology
2016;17(5):684-694
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: First, to investigate the diagnostic performance of fast T1-weighted sequences for lung nodule evaluation in oncologic magnetic resonance (MR)/positron emission tomography (PET). Second, to evaluate the influence of image acquisition in inspiration and expiration breath-hold on diagnostic performance. MATERIALS AND METHODS: The study was approved by the local Institutional Review Board. PET/CT and MR/PET of 44 cancer patients were evaluated by 2 readers. PET/CT included lung computed tomography (CT) scans in inspiration and expiration (CTin, CTex). MR/PET included Dixon sequence for attenuation correction and fast T1-weighted volumetric interpolated breath-hold examination (VIBE) sequences (volume interpolated breath-hold examination acquired in inspiration [VIBEin], volume interpolated breath-hold examination acquired in expiration [VIBEex]). Diagnostic performance was analyzed for lesion-, lobe-, and size-dependence. Diagnostic confidence was evaluated (4-point Likert-scale; 1 = high). Jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed. RESULTS: Seventy-six pulmonary lesions were evaluated. Lesion-based detection rates were: CTex, 77.6%; VIBEin, 53.3%; VIBEex, 51.3%; and Dixon, 22.4%. Lobe-based detection rates were: CTex, 89.6%; VIBEin, 58.3%; VIBEex, 60.4%; and Dixon, 31.3%. In contrast to CT, inspiration versus expiration did not alter diagnostic performance in VIBE sequences. Diagnostic confidence was best for VIBEin and CTex and decreased in VIBEex and Dixon (1.2 ± 0.6; 1.2 ± 0.7; 1.5 ± 0.9; 1.7 ± 1.1, respectively). The JAFROC figure-of-merit of Dixon was significantly lower. All patients with malignant lesions were identified by CTex, VIBEin, and VIBEex, while 3 patients were false-negative in Dixon. CONCLUSION: Fast T1-weighted VIBE sequences allow for identification of patients with malignant pulmonary lesions. The Dixon sequence is not recommended for lung nodule evaluation in oncologic MR/PET patients. In contrast to CT, inspiration versus expiratory breath-hold in VIBE sequences was less crucial for lung nodule evaluation but was important for diagnostic confidence.
