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Detecting small pulmonary nodules with spiral ultrashort echo time sequences in 1.5 T MRI.

Authors:
Yu-Sen Huang Emi Niisato Mao-Yuan Marine Su Thomas Benkert Hsao-Hsun Hsu Jin-Yuan Shih Jin-Shing Chen Yeun-Chung Chang

MAGMA 2021 Jun 9;34(3):399-409. Epub 2020 Sep 9.

Department of Medical Imaging, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 100, Taiwan.

Objective: This study investigated ultrashort echo time (UTE) sequences in 1.5 T magnetic resonance imaging (MRI) for small lung nodule detection.

Materials And Methods: A total of 120 patients with 165 small lung nodules before video-associated thoracoscopic resection were enrolled. MRI sequences included conventional volumetric interpolated breath-hold examination (VIBE, scan time 16 s), spiral UTE (TE 0.05 ms) with free-breathing (scan time 3.5-5 min), and breath-hold sequences (scan time 20 s). Chest CT provided a standard reference for nodule size and morphology. Nodule detection sensitivity was evaluated on a lobe-by-lobe basis.

Results: The nodule detection rate was significantly higher in spiral UTE free-breathing (> 78%, p < 0.05) and breath-hold sequences (> 75%, p < 0.05) compared with conventional VIBE (> 55%), reaching 100% when nodule size was > 16 mm, and reaching 95% when nodules were in solid morphology, regardless of size. The inter-sequence reliability between free-breathing and breath-hold spiral UTE was good (κ > 0.80). Inter-reader agreement was also high (κ > 0.77) for spiral UTE sequences. Nodule size measurements were consistent between CT and spiral UTE MRI, with a minimal bias up to 0.2 mm.

Discussion: Spiral UTE sequences detect small lung nodules that warrant surgery, offers realistic scan times for clinical work, and could be implemented as part of routine lung MRI.

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http://dx.doi.org/10.1007/s10334-020-00885-xDOI Listing
June 2021

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