Wang Funan, Lin Xi, Lin Chong, Huang Guoqiang, Li Min, Zhu Liuhong
Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.
Quant Imaging Med Surg. 2023 Mar 1;13(3):1792-1801. doi: 10.21037/qims-22-118. Epub 2023 Jan 2.
Radiation-free lung cancer screening will reduce/eliminate radiation exposure in the diagnosis and follow-up of patients with lung cancer.
This was a prospective study. The participants were recruited using convenience sampling. A total of 36 patients with pulmonary nodules [patients with single or multiple pulmonary nodules >4 and <30 mm on their pulmonary computed tomography (CT) scans] who were admitted to Fudan University Zhongshan Hospital's Xiamen branch were enrolled; they underwent a CT scan and a free-breathing ultrashort time-of-echo (UTE) sequence scan using a 3-Tesla (T) magnetic resonance imaging (MRI) scanner. The CT examinations were regarded as the reference standard. Patients had an interval time of <3 days between their CT and MRI examinations. Two reviewers with more than 10 years' experience in the diagnosis of pulmonary nodules identified the numbers and morphological features of the pulmonary nodules.
Among the 36 patients, 46 nodules were detected on CT images, 45 of which were also detected on UTE images (a detection rate of 97.6%). The detection rate for lobulation using UTE-MRI was 96.9%; however, the difference compared with the rate for the CT images was not statistically significant (P>0.05). In terms of confounding lesions (confounding lesions indicate that the patient has malignant tumours, benign nodules or inoperable nodules), the UTE-MRI method had a higher detection rate than the CT method, and the difference was significant (P<0.05). The probability of malignant lesions was found to be higher in confounding lesions than in homogeneous lesions. In terms of pleural traction, the UTE-MRI method demonstrated a higher detection rate (120%) than the CT method, but the difference was not statistically significant (P>0.05). In terms of spiculation, the UTE-MRI method demonstrated a lower detection rate (81.8%) than the CT method, although the difference was not statistically significant (P>0.05).
Overall, 3-T UTE-MRI imaging has a high detection rate for pulmonary nodules >4 mm and is similar to that of conventional CT imaging. The method can be used for radiation-free lung cancer screening and follow-up examinations to reduce/eliminate both repeat CT examinations and radiation damage.
无辐射肺癌筛查将减少/消除肺癌患者诊断和随访过程中的辐射暴露。
这是一项前瞻性研究。采用便利抽样法招募参与者。复旦大学附属中山医院厦门分院收治的36例肺结节患者（肺计算机断层扫描[CT]显示单个或多个肺结节，直径>4 mm且<30 mm）纳入研究；他们接受了CT扫描以及使用3特斯拉（T）磁共振成像（MRI）扫描仪进行的自由呼吸超短回波时间（UTE）序列扫描。CT检查被视为参考标准。患者的CT和MRI检查间隔时间<3天。两名在肺结节诊断方面有超过10年经验的阅片者确定了肺结节的数量和形态特征。
36例患者中，CT图像上检测到46个结节，其中45个在UTE图像上也被检测到（检测率为97.6%）。UTE-MRI对分叶的检测率为96.9%；然而，与CT图像的检测率相比，差异无统计学意义（P>0.05）。在混杂病变方面（混杂病变指患者患有恶性肿瘤、良性结节或不可手术的结节），UTE-MRI方法的检测率高于CT方法，且差异有统计学意义（P<0.05）。发现混杂病变中恶性病变的概率高于均匀病变。在胸膜牵拉方面，UTE-MRI方法的检测率（120%）高于CT方法，但差异无统计学意义（P>0.05）。在毛刺征方面，UTE-MRI方法的检测率（81.8%）低于CT方法，尽管差异无统计学意义（P>0.05）。
总体而言，3-T UTE-MRI成像对>4 mm的肺结节具有较高的检测率，与传统CT成像相似。该方法可用于无辐射肺癌筛查和随访检查，以减少/消除重复CT检查及辐射损伤。
