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Chest wall invasion by bronchogenic carcinoma: evaluation with MR imaging
B Padovani1, J Mouroux, L Seksik
1Department of Diagnostic Radiology, Hôpital Pasteur, Nice, France.
Abstract:
The value of magnetic resonance (MR) imaging and the roles of various pulse sequences and contrast medium enhancement in detection of chest wall invasion were evaluated in 34 patients with primary bronchogenic carcinoma. Results were correlated with clinical data and computed tomographic studies. MR imaging criteria of parietal invasion included signal intensity identical to that of the tumor on T1-weighted images, intraparietal hyperintense signal of the tumor on T2-weighted images, and intraparietal enhancement with T1-weighted imaging and gadoterate meglumine administration. Twenty patients had parietal involvement, and MR imaging was positive in 18 of the 20 (sensitivity, 90%). Two false-positive errors occurred among the 14 patients without parietal involvement (specificity, 86%). T2-weighted sequences had a sensitivity of 65% (11 of 17 cases). Contrast-enhanced and non-contrast-enhanced T1-weighted sequences had the same sensitivity, but contrast medium uptake was revealed in two patients without parietal involvement. Good spatial resolution appears to be the main factor for detection of parietal invasion.
Insights
Magnetic resonance (MR) imaging effectively detects chest wall invasion in lung cancer. Specific imaging criteria and good spatial resolution are key for accurate diagnosis, improving patient assessment.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Chest wall invasion is a critical factor in staging bronchogenic carcinoma.
- Accurate detection of chest wall invasion impacts treatment decisions and patient prognosis.
Purpose of the Study:
- To evaluate the diagnostic value of magnetic resonance (MR) imaging for detecting chest wall invasion in primary bronchogenic carcinoma.
- To assess the roles of different MR pulse sequences and contrast enhancement in identifying parietal involvement.
Main Methods:
- Retrospective analysis of 34 patients with primary bronchogenic carcinoma.
- Correlation of MR imaging findings with clinical data and computed tomography (CT) scans.
- Evaluation of T1-weighted, T2-weighted sequences, and contrast-enhanced T1-weighted imaging with gadoterate meglumine.
Main Results:
- MR imaging demonstrated 90% sensitivity and 86% specificity for detecting parietal involvement.
- Specific MR criteria included signal intensity on T1-weighted, hyperintense signal on T2-weighted, and contrast enhancement.
- T2-weighted sequences alone had lower sensitivity (65%).
- Good spatial resolution was identified as crucial for accurate detection.
Conclusions:
- MR imaging is a valuable tool for assessing chest wall invasion in lung cancer.
- Contrast-enhanced T1-weighted sequences and high spatial resolution improve diagnostic accuracy.
- MR imaging findings can guide treatment planning for patients with bronchogenic carcinoma.