Liu Qianyun, Feng Zhichao, Liu Weiyin Vivian, Fu Weidong, He Lei, Cheng Xiaosan, Mao Zhongliang, Zhou Wenming
Department of Medical Imaging, Yueyang Central Hospital, Yueyang, China.
Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China.
Front Oncol. 2022 Apr 26;12:812014. doi: 10.3389/fonc.2022.812014. eCollection 2022.
The aim of this study is to determine the potential of zero echo time (ZTE) MR lung imaging in the assessment of solid pulmonary nodules or masses and diagnostic consistency to CT in terms of morphologic characterization.
Our Institutional Review Board approved this prospective study. Seventy-one patients with solid pulmonary nodules or masses larger than 1 cm in diameter confirmed by chest CT were enrolled and underwent further lung ZTE-MRI scans within 7 days. ZTE-MRI and CT images were compared in terms of image quality and imaging features. Unidimensional diameter and three-dimensional volume measurements on both modalities were manually measured and compared using the Wilcoxon signed-rank test, intraclass correlation coefficient (ICC), Pearson's correlation analysis, and Bland-Altman analysis. Multivariable logistic regression analysis was used to identify the factors associated with significant inter-modality variation of volume.
Fifty-four of 71 (76.1%) patients were diagnosed with lung cancer. Subjective image quality was superior in CT compared with ZTE-MRI ( < 0.001). Inter-modality agreement for the imaging features was moderate for emphysema (kappa = 0.50), substantial for fibrosis (kappa = 0.76), and almost perfect (kappa = 0.88-1.00) for the remaining features. The size measurements including diameter and volume between ZTE-MRI and CT showed no significant difference ( = 0.36 for diameter and 0.60 for volume) and revealed perfect inter-observer (ICC = 0.975-0.980) and inter-modality (ICC = 0.942-0.992) agreements. Multivariable analysis showed that non-smooth margin [odds ratio (OR) = 6.008, = 0.015] was an independent predictor for the significant inter-modality variation of volume.
ZTE lung imaging is feasible as a part of chest MRI in the assessment and surveillance for solid pulmonary nodules or masses larger than 1 cm, presenting perfect agreement with CT in terms of morphologic characterization.
本研究旨在确定零回波时间（ZTE）磁共振肺部成像在评估实性肺结节或肿块方面的潜力，以及在形态学特征方面与CT的诊断一致性。
我们的机构审查委员会批准了这项前瞻性研究。纳入71例经胸部CT证实直径大于1 cm的实性肺结节或肿块患者，并在7天内接受进一步的肺部ZTE-MRI扫描。对ZTE-MRI和CT图像的图像质量和成像特征进行比较。在两种检查方式上手动测量一维直径和三维体积，并使用Wilcoxon符号秩检验、组内相关系数（ICC）、Pearson相关分析和Bland-Altman分析进行比较。采用多变量逻辑回归分析来确定与体积的显著模态间差异相关的因素。
71例患者中有54例（76.1%）被诊断为肺癌。主观图像质量方面，CT优于ZTE-MRI（<0.001）。成像特征的模态间一致性在肺气肿方面为中等（kappa = 0.50），在纤维化方面为实质性（kappa = 0.76），在其余特征方面几乎为完美（kappa = 0.88 - 1.00）。ZTE-MRI和CT之间包括直径和体积在内的大小测量无显著差异（直径为0.36，体积为0.60），并显示出完美的观察者间（ICC = 0.975 - 0.980）和模态间（ICC = 0.942 - 0.992）一致性。多变量分析表明，边缘不光滑[比值比（OR）= 6.008， = 0.015]是体积显著模态间差异的独立预测因素。
ZTE肺部成像作为胸部MRI的一部分，在评估和监测直径大于1 cm的实性肺结节或肿块方面是可行的，在形态学特征方面与CT表现出完美的一致性。
