Detection of pulmonary nodules with move-during-scan magnetic resonance imaging using a free-breathing turbo inversion recovery magnitude sequence

Detection of pulmonary metastases is still a challenging task for magnetic resonance imaging (MRI). It was the aim of this study to evaluate the potential of a free-breathing move-during-scan turbo inversion recovery magnitude sequence for the detection of pulmonary nodules.

The sensitivities and positive-predictive values of 2 radiologists to detect pulmonary nodules in 41 move-during-scan MRI examinations of 38 patients with different malignancies were calculated and subgroup analyses according to lesion size and localization were performed. Multidetector computed tomography served as the standard of reference. Additionally, 6 radiologists rated the confidence for the presence of nodular lesions in 212 regions-of-interest, which were randomly selected to represent lesions of various sizes as well as negative findings. Receiver-operator-characteristic was performed.

Three hundred twenty-one nodules were found in 30 patients by multidetector computed tomography. Sensitivity and specificity of MRI to detect pulmonary nodules larger than 3 mm on a per-patient basis were 81.8% and 94.7%, respectively. On a per-lesion basis, MRI revealed a sensitivity of 79.0% to 80.7% for lesions larger than 3 mm, if high conspicuity ratings were counted as positive, and 84.6%, if medium and high conspicuity ratings were counted as positive. Sensitivity increased uniformly with lesion size, and all lesions larger than 12 mm were detected. Receiver-operator-characteristic analysis revealed a mean accuracy of 0.90 and sensitivities over 90% for lesions larger than 3 mm with a specificity of 96.1%. For lesions larger than 6 mm the accuracy was 0.99.

Detection of pulmonary nodules with a move-during-scan turbo inversion recovery magnitude sequence is feasible. Excellent detection of lesions larger than 6 mm is achievable with free-breathing moving-table MRI.