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01-02-2014 | Chest

Characterisation of solitary pulmonary lesions combining visual perfusion and quantitative diffusion MR imaging

Authors: Johan Coolen, Johan Vansteenkiste, Frederik De Keyzer, Herbert Decaluwé, Walter De Wever, Christophe Deroose, Christophe Dooms, Eric Verbeken, Paul De Leyn, Vincent Vandecaveye, Dirk Van Raemdonck, Kristiaan Nackaerts, Steven Dymarkowski, Johny Verschakelen

Published in: European Radiology | Issue 2/2014

Abstract

Objective

To evaluate the diagnostic accuracy of dynamic contrast-enhanced (DCE) magnetic resonance (MR) and diffusion-weighted imaging (DWI) sequences for defining benignity or malignancy of solitary pulmonary lesions (SPL).

Methods

First, 54 consecutive patients with SPL, clinically staged (CT and PET or integrated PET-CT) as N0M0, were included in this prospective study. An additional 3-Tesla MR examination including DCE and DWI was performed 1 day before the surgical procedure. Histopathology of the surgical specimen served as the standard of reference. Subsequently, this functional method of SPL characterisation was validated with a second cohort of 54 patients.

Results

In the feasibility group, 11 benign and 43 malignant SPL were included. Using the combination of conventional MR sequences with visual interpretation of DCE-MR curves resulted in a sensitivity, specificity and accuracy of 100 %, 55 % and 91 %, respectively. These results can be improved by DWI (with a cut-off value of 1.52 × 10⁻³ mm²/s for ADC_high) leading to a sensitivity, specificity and accuracy of 98 %, 82 % and 94 %, respectively. In the validation group these results were confirmed.

Conclusion

Visual DCE-MR-based curve interpretation can be used for initial differentiation of benign from malignant SPL, while additional quantitative DWI-based interpretation can further improve the specificity.

Key Points

• Magnetic resonance imaging is increasingly being used to help differentiate lung lesions.

• Solitary pulmonary lesions (SPL) are accurately characterised by combining DCE-MRI and DWI.

• Visual DCE-MRI assessment facilitates the diagnostic throughput in patients with SPL.

• DWI provides additional information in inconclusive DCE-MRI (type B pattern).

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Title: Characterisation of solitary pulmonary lesions combining visual perfusion and quantitative diffusion MR imaging
Authors: Johan Coolen
Johan Vansteenkiste
Frederik De Keyzer
Herbert Decaluwé
Walter De Wever
Christophe Deroose
Christophe Dooms
Eric Verbeken
Paul De Leyn
Vincent Vandecaveye
Dirk Van Raemdonck
Kristiaan Nackaerts
Steven Dymarkowski
Johny Verschakelen
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-3053-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Characterisation of solitary pulmonary lesions combining visual perfusion and quantitative diffusion MR imaging

Abstract

Objective

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

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