Department of Diagnostic Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Eur Radiol. 2024 Feb;34(2):1065-1076. doi: 10.1007/s00330-023-10105-4. Epub 2023 Aug 15.
The purpose of this study was thus to compare capabilities for quantitative differentiation of non- and minimally invasive adenocarcinomas from other of pulmonary MRIs with ultra-short TE (UTE) obtained with single- and dual-echo techniques (UTE-MRI and UTE-MRI) and thin-section CT for stage IA lung cancer patients.
Ninety pathologically diagnosed stage IA lung cancer patients who underwent thin-section standard-dose CT, UTE-MRI and UTE-MRI, surgical treatment and pathological examinations were included in this retrospective study. The largest dimension (D), solid portion (solid D), and consolidation/tumor (C/T) ratio of each nodule were assessed. Two-tailed Student's t-tests were performed to compare all indexes obtained with each method between non- and minimally invasive adenocarcinomas and other lung cancers. Receiver operating characteristic (ROC)-based positive tests were performed to determine all feasible threshold values for distinguishing non- or minimally invasive adenocarcinoma (MIA) from other lung cancers. Sensitivity, specificity, and accuracy were then compared by means of McNemar's test.
Each index showed significant differences between the two groups (p < 0.0001). Specificities and accuracies of solid D for UTE-MRI and CT were significantly higher than those of solid D for UTE-MRI and UTE-MRI and all C/T ratios except CT (p < 0.05). Moreover, the specificities and accuracies of solid D and C/T ratio were significantly higher than those of D for each method (p < 0.05).
Pulmonary MRI with UTE is considered at least as valuable as thin-section CT for quantitative differentiation of non- and minimally invasive adenocarcinomas from other stage IA lung cancers.
Pulmonary MRI with UTE's capability for quantitative differentiation of non- and minimally invasive adenocarcinomas from other lung cancers in stage IA lung cancer patients is equal or superior to that of thin-section CT.
• Correlations were excellent for pathologically examined nodules with the largest dimensions (D) and a solid component (solid D) for all indexes (0.95 ≤ r ≤ 0.99, p < 0.0001). • Pathologically examined D and solid D obtained with all methods showed significant differences between non- and minimally invasive adenocarcinomas and other lung cancers (p < 0.0001). • Solid tumor components are most accurately measured by UTE-MRI and CT, whereas the ground-glass component is imaged by UTE-MRI and CT with high accuracy. UTE-MRI predicts tumor invasiveness with 100% sensitivity and 87.5% specificity at a C/T threshold of 0.5.
本研究旨在比较超短回波时间（UTE）单回波和双回波技术（UTE-MRI 和 UTE-MRI）获得的肺部 MRI 与薄层 CT 定量区分非浸润性和微浸润性腺癌与其他肺癌的能力，对接受手术治疗的 IA 期肺癌患者进行评估。
回顾性分析了 90 例经病理证实的 IA 期肺癌患者，这些患者均接受了薄层标准剂量 CT、UTE-MRI 和 UTE-MRI 检查。评估了每个结节的最大直径（D）、实性部分（实性 D）和实变/肿瘤（C/T）比值。采用双尾 Student's t 检验比较每种方法在非浸润性和微浸润性腺癌与其他肺癌之间获得的所有指标。基于受试者工作特征（ROC）的阳性检验确定区分非浸润性腺癌（MIA）或微浸润性腺癌与其他肺癌的所有可行阈值。然后通过 McNemar 检验比较敏感性、特异性和准确性。
两组间各指标均有显著差异（p<0.0001）。与 UTE-MRI 和 CT 的实性 D 相比，所有 C/T 比值（除 CT 外）和 UTE-MRI 的实性 D 的特异性和准确性均较高（p<0.05）。此外，与每种方法的 D 相比，实性 D 和 C/T 比值的特异性和准确性均较高（p<0.05）。
对于 IA 期肺癌患者，超短回波时间的肺部 MRI 与薄层 CT 一样可用于定量区分非浸润性和微浸润性腺癌与其他肺癌。
对于 IA 期肺癌患者，超短回波时间肺部 MRI 定量区分非浸润性和微浸润性腺癌与其他肺癌的能力与薄层 CT 相当或优于薄层 CT。
• 所有指标的病理检查结节的最大尺寸（D）和实性成分（实性 D）之间的相关性均极好（0.95≤r≤0.99，p<0.0001）。• 所有方法的病理 D 和实性 D 均显示非浸润性和微浸润性腺癌与其他肺癌之间存在显著差异（p<0.0001）。• 实性肿瘤成分可通过 UTE-MRI 和 CT 最准确测量，而磨玻璃成分可通过 UTE-MRI 和 CT 高度准确成像。当 C/T 阈值为 0.5 时，UTE-MRI 预测肿瘤侵袭性的灵敏度为 100%，特异性为 87.5%。
