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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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.
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.
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
• 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.
KeywordsMagnetic resonance imaging Multidetector computed tomography Lung Lung neoplasms Early detection of cancer
Low-dose computed tomography
Lung Screening Reporting and Data System
MultiVane XD (Philips Healthcare, Best, The Netherlands)
Non-small cell lung cancer
Small cell lung cancer
- THRIVE T1
High Resolution Isotropic Volume Excitation (Philips Healthcare)
The authors state that this work has not received any funding.
Compliance with ethical standards
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.
Written informed consent was obtained from all patients in this study.
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.
• diagnostic study
• performed at one institution
- 2.American College of Radiology. Lung CT Screening Reporting and Data System (Lung-RADS). Available at: http://www.acr.org/ Quality-Safety/Resources/LungRADS. Accessed 30 Nov 2017
- 4.Wielpütz M, Kauczor HU (2012) MRI of the lung: state of the art. Diagn Interv Radiol 18(4):344–353Google Scholar
- 9.Meier-Schroers M, Homsi R, Skowasch D, Buermann J, Zipfel M, Schild HH, Thomas D (2017) Lung cancer screening with MRI: results of the first screening round. J Cancer Res Clin Oncol. https://doi.org/10.1007/s00432-017-2521-4