Magnetic resonance appearance of asbestos-related benign and malignant pleural diseases

Early Contrast Enhancement: A novel magnetic resonance imaging biomarker of pleural malignancy

“…[ 20 ] Our data suggest that ECE is, potentially, a more useful diagnostic tool since the median pleural thickness in this study was 5 mm. Despite this, ECE was measurable in all patients and produced similar diagnostic performance to these earlier studies of more advanced pleural disease [ 33 , 34 ].…”

“…The diagnostic performance of ECE was similar to two earlier MRI morphology studies, in which pleural hyper-intensity on T1-weighted gadolinium-enhanced images accurately discriminated malignant from benign pleural disease. [ 33 , 34 ] These studies also reported similar false positive results in patients with tuberculous pleurisy, possibly reflecting angiogenesis in active tuberculous lesions. [ 35 , 36 ] However, it is important to note that the patients in these earlier studies had pleural thickening >10 mm, or pleural thickening that was significant, but not specifically measured.…”

British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma

“…Malignant pleural thickening tends to show inhomogenous hyperintensity on proton-density T2-weighted images and enhancement on T1-weighted images following gadolinium injection, in contradistinction to benign disease that is of low signal on both sequences. When these signal characteristics are combined with morphology and a pleural thickening >1 cm, the accuracy of MRI is very high for differentiation of benign from malignant disease with sensitivity of 100% and specificity of 95% in one study (95% confidence intervals not reported) 30 . More recent studies have highlighted potential utility for diffusion-weighted MR imaging (DWI-MRI) in differentiating pleural malignancy from benign pleural disease, with lower Apparent Diffusion Coefficient (ADC) values being demonstrated in pleural malignancy 31 32 .…”

The use of magnetic resonance imaging in malignant mesothelioma

“…E-mail address: james.entwisle@uhl-tr.nhs.uk (J. Entwisle). tients with asbestos exposure [1,2]. MPM typically appears hyperintense on T2 weighted imaging and enhances following intravenous (IV) gadolinium contrast on T1 weighted images.…”