Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127, Bonn, Germany.
Philips Healthcare Germany, Lübeckertordamm 5, 20099, Hamburg, Germany.
Eur Radiol. 2019 Feb;29(2):898-905. doi: 10.1007/s00330-018-5607-8. Epub 2018 Jul 10.
To evaluate MRI for lung cancer screening comparing LDCT- and MRI-derived Lung-RADS categories in the first two screening rounds.
224 participants in a lung cancer screening study were examined with MRI and low-dose CT (LDCT). Acquired MRI sequences were T2, balanced, T1 and DWI. MRI was prospectively analysed regarding nodules. Minimum nodule size was 4 mm. Nodules were assigned a Lung-RADS score based on appearance and size at baseline and after 3, 6 and 12 months. MRI findings were correlated with LDCT.
The early recall rate dropped from 13.8% at baseline to 1.9% in the second screening round with biopsy rates of 3.6% in the first round and 0.5% in the second round. Histology revealed lung cancer in 8/9 participants undergoing biopsy/surgery. All eight cancers were accurately depicted by MRI. The following categories were assigned on MRI (results of LDCT in parentheses): 4B/4X in 10 (10) cases, 4A in 16 (15) cases, 3 in 13 (12) cases, 2 in 77 (92) cases and 1 in 140 (126) cases. Lung-RADS scoring correlated significantly between MRI and CT. The score was overestimated by MRI in one case for category 4A, in two cases for category 3 and in five cases for category 2. MRI-based Lung-RADS score was underestimated for category 1 in 20 cases.
Lung-RADS might be applied for lung cancer screening with MRI, since findings correlated with LDCT. Relevant findings with a Lung-RADS score of 3 and higher were never missed or underestimated by MRI KEY POINTS: • MRI performed comparably to low-dose CT in a lung cancer-screening programme. • Lung-RADS might be applied for lung cancer screening with MRI. • Lung-RADS findings score of 3 and higher were never missed by MRI.
比较低剂量 CT（LDCT）和 MRI 衍生的 Lung-RADS 类别，评估肺癌筛查中 MRI 的作用，在头两个筛查轮次中。
在一项肺癌筛查研究中，对 224 名参与者进行了 MRI 和低剂量 CT（LDCT）检查。采集的 MRI 序列为 T2、平衡、T1 和 DWI。前瞻性分析 MRI 对结节的结果。结节的最小直径为 4mm。根据基线和 3、6 和 12 个月时的外观和大小，将结节分配一个 Lung-RADS 评分。MRI 结果与 LDCT 相关。
早期召回率从基线时的 13.8%下降到第二轮的 1.9%，活检率分别为第一轮的 3.6%和第二轮的 0.5%。在接受活检/手术的 9 名参与者中，组织学发现了 8 例肺癌。所有 8 例癌症均通过 MRI 准确显示。MRI 下分配了以下类别（括号中为 LDCT 结果）：4B/4X（10 例，10 例）、4A（16 例，15 例）、3（13 例，12 例）、2（77 例，92 例）和 1（140 例，126 例）。MRI 和 CT 之间的 Lung-RADS 评分显著相关。MRI 对 1 例 4A 类别高估，2 例 3 类别低估，5 例 2 类别低估。MRI 对 1 例 1 类别低估 20 例。
由于 MRI 与 LDCT 相关，因此可以将 Lung-RADS 应用于 MRI 肺癌筛查。
MRI 在肺癌筛查计划中与低剂量 CT 相比表现相当。
MRI 可用于肺癌筛查中的 Lung-RADS。
MRI 从未遗漏或低估 Lung-RADS 评分 3 分及以上的发现。
