Dynamic Magnetic Resonance Imaging of Solitary Pulmonary Nodules

Tozaki, Mitsuhiro; Ichiba, Noriatsu; Fukuda, Kunihiko

doi:10.1097/01.rct.0000153287.79730.9b

Cited by 26 publications

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“…Features, such as size, morphology, and rate of growth, often help to determine the likelihood of malignancy. [6–9] Common benign causes of benign lung nodules include infectious granulomas and hamartomas, whereas common malignant causes include primary lung cancer, carcinoid tumors, and lung metastases. [6]…”

Section: Discussionmentioning

confidence: 99%

Solitary pulmonary nodule: A diagnostic algorithm in the light of current imaging technique

et al. 2011

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The solitary pulmonary nodule (SPN) is frequently seen on chest radiographs and computed tomography (CT). The finding of a SPN usually provokes a flurry of clinical and imaging activity as an SPN in at-risk population is an alert signal of possible lung cancer. The frequency of malignant nodules in a given population is variable and depends on the endemicity of granulomatous disease. The percentage of malignant nodules also rises when dealing with at-risk population. The problem is compounded by the fact that with the present generation of CT scanners, 1–2 mm nodules are discovered in approximately half of the smokers aged 50 years or older scanned. A variety of management approaches are applied in the work-up of SPN often requiring evaluation over a long period of time to establish a benign or malignant diagnosis. Comparison with previous imaging studies and morphologic evaluation of the size, margins, and internal characteristics are usually the first step in the evaluation of these nodules. It is often necessary to use additional imaging techniques and occasionally invasive procedures such a percutaneous needle lung or a surgical biopsy. Until recently, the guidelines for follow-up of indeterminate noncalcified nodules detected on nonscreening CT was a minimum of 2 years. However, during the past few years due to further refinements in CT technology and better understanding of tumor behavior, it has prompted a revision of the guidelines of the follow-up of small indeterminate nodules. These guidelines have been endorsed by the Fleischner Society.

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Section: Discussionmentioning

confidence: 99%

Solitary pulmonary nodule: A diagnostic algorithm in the light of current imaging technique

et al. 2011

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“…In our study, malignant masses showed heterogeneous enhancement. Tozaki et al ( 25 ) reported prominent internal enhancement with PE for malignant masses and negligible internal enhancement with PE. Our results are in accordance with that report.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Dynamic Contrast Enhanced Magnetic Resonance Imaging in Characterizing Lung Masses

et al. 2016

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BackgroundImaging plays a critical role not only in the detection, but also in the characterization of lung masses as benign or malignant.ObjectivesTo determine the diagnostic accuracy of dynamic magnetic resonance imaging (MRI) in the differential diagnosis of benign and malignant lung masses.Patients and MethodsNinety-four masses were included in this prospective study. Five dynamic series of T1-weighted spoiled gradient echo (FFE) images were obtained, followed by a T1-weighted FFE sequence in the late phase (5th minutes). Contrast enhancement patterns in the early (25th second) and late (5th minute) phase images were evaluated. For the quantitative evaluation, signal intensity (SI)-time curves were obtained and the maximum relative enhancement, wash-in rate, and time-to-peak enhancement of masses in both groups were calculated.ResultsThe early phase contrast enhancement patterns were homogeneous in 78.2% of the benign masses, while heterogeneous in 74.4% of the malignant tumors. On the late phase images, 70.8% of the benign masses showed homogeneous enhancement, while most of the malignant masses showed heterogeneous enhancement (82.4%). During the first pass, the maximum relative enhancement and wash-in rate values of malignant masses were significantly higher than those of the benign masses (P = 0.03 and 0.04, respectively). The cutoff value at 15% yielded a sensitivity of 85.4%, specificity of 61.2%, and positive predictive value of 68.7% for the maximum relative enhancement.ConclusionContrast enhancement patterns and SI-time curve analysis of MRI are helpful in the differential diagnosis of benign and malignant lung masses.

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“…Відносною діагностичною ознакою вважають контури легеневих вузлів. Дані 6 досліджень [44,46,49,51,53,63] з групами пацієнтів із виявленими випадково або під час скринінгу солітарними вузлами свідчать, що ризик злоякісності становив 20-30 % для вузлів із гладкими контурами, хоча в одному з досліджень [46] зареєстрована поширеність злоякісних новоутворень 58 % випадків. Для вузлів із нерівними контурами, звивистими або загостреними краями (спікулоподібними («spicula»)) ризик злоякісності був вищим, але варіабельним (від 33 до 100 %).…”

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Solitary focal lung lesions: modern views on the diagnosis and medical tactics of their management. Literature review

Liskina¹

2022

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A review of the literature is devoted to highlighting of the main points relating to the modern actual multidisciplinary problem — single or solitary lung nodules with incidental detection. The main terms that are used in the study of such lesions or the more common term — nodules, as well as their definition are given. Known pathology causes for the development of solitary pulmonary nodules are also presented. The morphological characteristics of such nodules are described by X-ray or tomogram. The main problem if such nodules are detected is to establish their nature and, above all, their malignant or benign nature. Since the further medical tactic of their management are exactly different. Now the main attention is paid to malignant tumors, since they require the fastest most reliable identification and appropriate medical actions.It has been established that accurate determination of nodules etiology by the main indicators of their radiological images is impossible. Although certain dependences of the malignancy risk of nodules on their size, contours and features of optical density have been identified. And only a morphological study allows us to establish the true nature of the nodules. It is believed that over diagnostics of malignancy of pulmonary nodules leads to excessive use of expensive invasive diagnostic procedures, and to some extent harms the patient in cases of benign nodules. The review ends with a list of possible options for medical management when solitary lung nodules of unknown origin are detected. Their disadvantages and advantages are briefly presented.

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Dynamic Magnetic Resonance Imaging of Solitary Pulmonary Nodules

Abstract: A combination of morphologic criteria and kinetic information is useful for differentiating between benign and malignant SPNs. In particular, internal enhancement with PE and positive visual washout is thought be a useful tool.

Cited by 26 publications

References 26 publications

Solitary pulmonary nodule: A diagnostic algorithm in the light of current imaging technique

Solitary pulmonary nodule: A diagnostic algorithm in the light of current imaging technique

Diagnostic Accuracy of Dynamic Contrast Enhanced Magnetic Resonance Imaging in Characterizing Lung Masses

Solitary focal lung lesions: modern views on the diagnosis and medical tactics of their management. Literature review

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