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Usefulness of contrast-enhanced magnetic resonance imaging for evaluating solitary pulmonary nodules.

Fujimoto K - Cancer Imaging (2008)

Bottom Line: Although the clinical role of magnetic resonance imaging (MRI) for SPNs remains limited, considerable experience has been gained with MRI of thoracic diseases.Dynamic MRI and dynamic CT are useful for differentiating between malignant and benign SPNs (especially tuberculomas and hamartomas).Furthermore, dynamic MRI is useful for assessing tumor vascularity, interstitium, and vascular endothelial growth factor expression, and for predicting survival outcome among patients with peripheral pulmonary carcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Kurume University School of Medicine and Center for Diagnostic Imaging, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011 Japan. kimichan@med.kurume-u.ac.jp

ABSTRACT
Evaluation of solitary pulmonary nodules (SPNs) poses a challenge to radiologists. Chest computed tomography (CT) is considered the standard technique for assessing morphologic findings and intrathoracic spread of an SPN. Although the clinical role of magnetic resonance imaging (MRI) for SPNs remains limited, considerable experience has been gained with MRI of thoracic diseases. Dynamic MRI and dynamic CT are useful for differentiating between malignant and benign SPNs (especially tuberculomas and hamartomas). Furthermore, dynamic MRI is useful for assessing tumor vascularity, interstitium, and vascular endothelial growth factor expression, and for predicting survival outcome among patients with peripheral pulmonary carcinoma. These advantages make dynamic MRI a promising method and a potential biomarker for characterizing tumor response to anti-angiogenic treatment as well as for predicting survival outcomes after treatment.

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A case of focal organizing pneumonia in a 52-year-old woman. The dynamic MRI scans with fast spin-echo sequence were acquired before (A) and 3 min (B) and 8 min (C) after gadopentetate dimeglumine injection. Dynamic MRI reveals a nodular lesion (arrow) showing an early and strong enhancement peak and slight washout pattern.
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Figure 4: A case of focal organizing pneumonia in a 52-year-old woman. The dynamic MRI scans with fast spin-echo sequence were acquired before (A) and 3 min (B) and 8 min (C) after gadopentetate dimeglumine injection. Dynamic MRI reveals a nodular lesion (arrow) showing an early and strong enhancement peak and slight washout pattern.

Mentions: In summary, assessments of the maximum enhancement ratio and the slope value of dynamic MRI are helpful in differentiating benign SPNs (especially tuberculomas and hamartomas) and focal organizing pneumonias from lung cancers. The absence of significant enhancement is a strong predictor that an SPN is benign17,20. However, acute inflammatory lesions and active infection are often difficult to differentiate from malignant lesions based only on the perfusion characteristics (Fig. 4). A recent paper on short-term follow-up CT within 2 months30 demonstrates that some focal lesions regress spontaneously at short term follow-up confirming the benign nature of the lesions. It is assumed that many of the lesions represent focal areas of pneumonia. Therefore, when a well-enhancing SPN with an early peak necessitating further evaluation is found, it might be useful to perform short-term follow-up CT.Figure 4


Usefulness of contrast-enhanced magnetic resonance imaging for evaluating solitary pulmonary nodules.

Fujimoto K - Cancer Imaging (2008)

A case of focal organizing pneumonia in a 52-year-old woman. The dynamic MRI scans with fast spin-echo sequence were acquired before (A) and 3 min (B) and 8 min (C) after gadopentetate dimeglumine injection. Dynamic MRI reveals a nodular lesion (arrow) showing an early and strong enhancement peak and slight washout pattern.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2267694&req=5

Figure 4: A case of focal organizing pneumonia in a 52-year-old woman. The dynamic MRI scans with fast spin-echo sequence were acquired before (A) and 3 min (B) and 8 min (C) after gadopentetate dimeglumine injection. Dynamic MRI reveals a nodular lesion (arrow) showing an early and strong enhancement peak and slight washout pattern.
Mentions: In summary, assessments of the maximum enhancement ratio and the slope value of dynamic MRI are helpful in differentiating benign SPNs (especially tuberculomas and hamartomas) and focal organizing pneumonias from lung cancers. The absence of significant enhancement is a strong predictor that an SPN is benign17,20. However, acute inflammatory lesions and active infection are often difficult to differentiate from malignant lesions based only on the perfusion characteristics (Fig. 4). A recent paper on short-term follow-up CT within 2 months30 demonstrates that some focal lesions regress spontaneously at short term follow-up confirming the benign nature of the lesions. It is assumed that many of the lesions represent focal areas of pneumonia. Therefore, when a well-enhancing SPN with an early peak necessitating further evaluation is found, it might be useful to perform short-term follow-up CT.Figure 4

Bottom Line: Although the clinical role of magnetic resonance imaging (MRI) for SPNs remains limited, considerable experience has been gained with MRI of thoracic diseases.Dynamic MRI and dynamic CT are useful for differentiating between malignant and benign SPNs (especially tuberculomas and hamartomas).Furthermore, dynamic MRI is useful for assessing tumor vascularity, interstitium, and vascular endothelial growth factor expression, and for predicting survival outcome among patients with peripheral pulmonary carcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Kurume University School of Medicine and Center for Diagnostic Imaging, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011 Japan. kimichan@med.kurume-u.ac.jp

ABSTRACT
Evaluation of solitary pulmonary nodules (SPNs) poses a challenge to radiologists. Chest computed tomography (CT) is considered the standard technique for assessing morphologic findings and intrathoracic spread of an SPN. Although the clinical role of magnetic resonance imaging (MRI) for SPNs remains limited, considerable experience has been gained with MRI of thoracic diseases. Dynamic MRI and dynamic CT are useful for differentiating between malignant and benign SPNs (especially tuberculomas and hamartomas). Furthermore, dynamic MRI is useful for assessing tumor vascularity, interstitium, and vascular endothelial growth factor expression, and for predicting survival outcome among patients with peripheral pulmonary carcinoma. These advantages make dynamic MRI a promising method and a potential biomarker for characterizing tumor response to anti-angiogenic treatment as well as for predicting survival outcomes after treatment.

Show MeSH
Related in: MedlinePlus