Meier-Schroers Michael, Homsi Rami, Skowasch Dirk, Buermann Jens, Zipfel Matthias, Schild Hans Heinz, Thomas Daniel
Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127, Bonn, Germany.
Department of Cardiology, Pneumology and Angiology, University of Bonn, Sigmund-Freud-Str 25, 53127, Bonn, Germany.
J Cancer Res Clin Oncol. 2018 Jan;144(1):117-125. doi: 10.1007/s00432-017-2521-4. Epub 2017 Sep 20.
To evaluate the suitability of MRI for lung cancer screening in a high-risk population.
A 5-year lung cancer screening program comparing MRI and low-dose CT (LDCT) in a high-risk population was initiated. 224 subjects were examined with MRI and LDCT. Acquired MRI sequences were T2w MultiVane XD, balanced steady-state-free precession, 3D T1w GRE, and DWI with a maximum in-room-time of 20 min. Categorization and management of nodules were based on Lung-RADS. MRI findings were correlated with LDCT as a reference. Here, we report on the first screening round.
MRI accurately detected 61 of 88 nodules 4-5 mm, 20 of 21 nodules 6-7 mm, 12 of 12 nodules 8-14 mm, 4 of 4 nodules ≥ 15 mm (solid nodules), and 8 of 11 subsolid nodules. Sensitivity/specificity of MRI for nodule detection was 69.3/96.4% for 4-5 mm, 95.2/99.6% for 6-7 mm, 100/99.6% for 8-14 mm, 100/100% for ≥ 15 mm (solid nodules), and 72.7/99.2% for subsolid nodules. The early recall rate was 13.8% for MRI and 12.5% for LDCT. Following Lung-RADS recommendations and based on interdisciplinary consensus, histology was obtained in eight subjects. The biopsy rate was 3.6% for MRI and 3.4% for LDCT. In all of these eight cases, the nodules were carcinomas, and all of them were accurately detected by MRI.
The results of the first screening round suggest that MRI is suitable for lung cancer screening with an excellent sensitivity and specificity for nodules ≥ 6 mm.
评估磁共振成像（MRI）在高危人群中进行肺癌筛查的适用性。
启动了一项为期5年的肺癌筛查项目，在高危人群中比较MRI和低剂量计算机断层扫描（LDCT）。对224名受试者进行了MRI和LDCT检查。采集的MRI序列包括T2加权多叶片XD序列、平衡稳态自由进动序列、三维T1加权梯度回波序列和扩散加权成像（DWI）序列，检查室内最长时间为20分钟。结节的分类和处理基于肺癌影像报告和数据系统（Lung-RADS）。以LDCT为参考，将MRI检查结果与之进行对比。在此，我们报告第一轮筛查情况。
MRI准确检测出88个4 - 5毫米结节中的61个、21个6 - 7毫米结节中的20个、12个8 - 14毫米结节中的12个、4个≥15毫米（实性结节）结节中的4个以及11个亚实性结节中的8个。MRI检测结节的敏感度/特异度在4 - 5毫米结节中为69.3/96.4%，在6 - 7毫米结节中为95.2/99.6%，在8 - 14毫米结节中为100/99.6%，在≥15毫米（实性结节）结节中为100/100%，在亚实性结节中为72.7/99.2%。MRI的早期召回率为13.8%，LDCT的早期召回率为12.5%。根据Lung-RADS建议并基于多学科共识，对8名受试者进行了组织学检查。MRI的活检率为3.6%，LDCT的活检率为3.4%。在这8例病例中，所有结节均为癌，且均被MRI准确检测出。
第一轮筛查结果表明，MRI适用于肺癌筛查，对≥6毫米的结节具有出色的敏感度和特异度。
