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Lung cancer screening with MRI: Evaluation of MRI for lung cancer screening by comparison of LDCT- and MRI-derived Lung-RADS categories in the first two screening rounds

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Abstract

Purpose

To evaluate MRI for lung cancer screening comparing LDCT- and MRI-derived Lung-RADS categories in the first two screening rounds.

Materials and methods

224 participants in a lung cancer screening study were examined with MRI and low-dose CT (LDCT). Acquired MRI sequences were T2, balanced, T1 and DWI. MRI was prospectively analysed regarding nodules. Minimum nodule size was 4 mm. Nodules were assigned a Lung-RADS score based on appearance and size at baseline and after 3, 6 and 12 months. MRI findings were correlated with LDCT.

Results

The early recall rate dropped from 13.8% at baseline to 1.9% in the second screening round with biopsy rates of 3.6% in the first round and 0.5% in the second round. Histology revealed lung cancer in 8/9 participants undergoing biopsy/surgery. All eight cancers were accurately depicted by MRI. The following categories were assigned on MRI (results of LDCT in parentheses): 4B/4X in 10 (10) cases, 4A in 16 (15) cases, 3 in 13 (12) cases, 2 in 77 (92) cases and 1 in 140 (126) cases. Lung-RADS scoring correlated significantly between MRI and CT. The score was overestimated by MRI in one case for category 4A, in two cases for category 3 and in five cases for category 2. MRI-based Lung-RADS score was underestimated for category 1 in 20 cases.

Conclusion

Lung-RADS might be applied for lung cancer screening with MRI, since findings correlated with LDCT. Relevant findings with a Lung-RADS score of 3 and higher were never missed or underestimated by MRI

Key Points

• MRI performed comparably to low-dose CT in a lung cancer-screening programme.

• Lung-RADS might be applied for lung cancer screening with MRI.

• Lung-RADS findings score of 3 and higher were never missed by MRI.

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Abbreviations

DWI:

Diffusion-weighted imaging

LDCT:

Low-dose computed tomography

Lung-RADS:

Lung Screening Reporting and Data System

MVXD:

MultiVane XD (Philips Healthcare, Best, The Netherlands)

NSCLC:

Non-small cell lung cancer

SCLC:

Small cell lung cancer

THRIVE T1:

High Resolution Isotropic Volume Excitation (Philips Healthcare)

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127, Bonn, Germany

    Michael Meier-Schroers, Rami Homsi, Hans Heinz Schild & Daniel Thomas

  2. Philips Healthcare Germany, Lübeckertordamm 5, 20099, Hamburg, Germany

    Jürgen Gieseke

Authors
  1. Michael Meier-Schroers
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  2. Rami Homsi
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  3. Jürgen Gieseke
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  4. Hans Heinz Schild
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  5. Daniel Thomas
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Corresponding author

Correspondence to Daniel Thomas.

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Guarantor

The scientific guarantor of this publication is Daniel Thomas.

Conflict of interest

One co-author of this manuscript, Jürgen Gieseke, is an employee of Philips Healthcare Germany. However, he did not have any influence on the study design, evaluation or interpretation of results. His main contribution was optimising the MR sequences and reviewing the manuscript.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all patients in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

All study subjects are participants of our lung cancer screening program. The performance of MRI regarding the detection of lung nodules in the first screening round were published in 2017 (Meier-Schroers M, Homsi R, Skowasch D, Buermann J, Zipfel M, Schild HH, Thomas D. Lung cancer screening with MRI: results of the first screening round. J Cancer Res Clin Oncol. 2017 Sep 20. [Epub ahead of print]). The current study reports on the first two screening rounds including all follow-ups and on the applicability of the Lung-RADS classification.

Methodology

• prospective

• diagnostic study

• performed at one institution

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Meier-Schroers, M., Homsi, R., Gieseke, J. et al. Lung cancer screening with MRI: Evaluation of MRI for lung cancer screening by comparison of LDCT- and MRI-derived Lung-RADS categories in the first two screening rounds. Eur Radiol 29, 898–905 (2019). https://doi.org/10.1007/s00330-018-5607-8

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  • DOI: https://doi.org/10.1007/s00330-018-5607-8

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