A preliminary study of MRI quantification of simulated calcified pulmonary nodules

The potential of magnetic resonance imaging (MRI) quantification of calcium for the evaluation of pulmonary nodules was investigated in simulated nodules. Calcium salts do not contain mobile protons and thus have no signal on MR proton images. To determine whether the absence of signal from partially calcified nodules could be quantified, we studied simulated nodules containing known quantities of calcium salts. The soft tissue equivalent material was an agar-gelatin mixture (T1:1100-1500 msec; T2: 59-62 msec). In the first experiments, glass tubes were filled with the mixture, which contained suspensions of calcium carbonate (CaCO3) or silica dioxide (Si02), and were subjected to computed tomography (CT) scanning and MR imaging. In a second series of studies CaCO3 particles of various sizes (and therefore different surface-to-volume ratios) were similarly suspended and subjected to CT scanning and MR imaging. In a third series hydroxyapatite (HA) suspensions of different sizes were similarly studied. CaCO3 produced a significant reduction in MR hydrogen density and signal intensity of the agar-gelatin mixture. Reduction in T1 and T2 relaxation times was inconsistent and not related to particle size. CaCO3 produced its effect by soft-tissue displacement. HA (and Si02) caused a more marked fall in MR hydrogen density, signal intensity, and T1 and T2 relaxation times. The degree of the T1 and T2 effects was related to particle size, indicating a hydrophilic surface effect. The authors conclude that MRI quantification of calcium within pulmonary nodules (or other tissues) will be complex and will relate to the precise composition of the calcium salt and to the particle size of the aggregates.