Dynamic MR imaging: value of differentiating subtypes of peripheral small adenocarcinoma of the lung

Ohno, Yoshiharu; Hatabu, Hiroto; Takenaka, Daisuke; Uematsu, Hidemasa; Ohbayashi, Chiho; Higashino, Takanori; Nogami, Munenobu; Yoshimura, Masahiro; Fujii, Masahiko; Sugimura, Kazuro

doi:10.1016/j.ejrad.2004.01.015

« Previous Next »European Journal of Radiology
Volume 52, Issue 2 , Pages 144-150, November 2004

Dynamic MR imaging: value of differentiating subtypes of peripheral small adenocarcinoma of the lung

Yoshiharu Ohno
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
- Pulmonary Functional Imaging Research, Department of Radiology, University of Pennsylvania Medical Center, 3600 Market Street, Suite 370, Philadelphia, PA 19104-2649, USA
- Corresponding author. Tel.: +81-78-382-6104; fax: +81-78-382-6129.
Hiroto Hatabu
- Pulmonary Functional Imaging Research, Department of Radiology, University of Pennsylvania Medical Center, 3600 Market Street, Suite 370, Philadelphia, PA 19104-2649, USA
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, AN-241, Boston, MA 02115, USA
Daisuke Takenaka
- Department of Radiology, Kasai Municipal Hospital, 1-13, Yokoo Houzyou-chou, Kasai, Hyogo 675-2311, Japan
Hidemasa Uematsu
- Pulmonary Functional Imaging Research, Department of Radiology, University of Pennsylvania Medical Center, 3600 Market Street, Suite 370, Philadelphia, PA 19104-2649, USA
Chiho Ohbayashi
- Division of Pathology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Takanori Higashino
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Munenobu Nogami
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Masahiro Yoshimura
- Division of Cardiovascular, Thoracic and Pediatric Surgery, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Masahiko Fujii
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
Kazuro Sugimura
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan

Received 22 September 2003; received in revised form 24 January 2004; accepted 27 January 2004.

Abstract

Purpose: To determine the utility of dynamic magnetic resonance imaging (MRI) in the differential subtyping of small adenocarcinomas of the lung. Materials and methods: Twenty-nine pathologically diagnosed peripheral adenocarcinomas (less than 20mm in diameter) underwent dynamic contrast-enhanced MRI. Maximum relative enhancement ratio, slope of enhancement, and corrected start time of enhancement were calculated from signal intensity–time curve of pulmonary lesion for each subject, and were statistically compared among bronchioloalveolar carcinoma (BAC) group (7 cases), mixed BAC group (10 cases), and adenocarcinoma group (12 cases). Results: Maximum relative enhancement ratio (P<0.001) and slope of enhancement (P<0.001) of BAC group were significantly higher than those of mixed BAC and adenocarcinoma groups. Start times of BAC group were significantly earlier than those of mixed BAC (P=0.0001) and adenocarcinoma groups (P<0.0001). Adapting the thresholds values of MR indexes from the positive tests, sensitivity, specificity, positive predictive value, negative predictive value and accuracy for differentiating BAC from other subtypes were 85.7, 100.0, 100.0, 95.7, and 96.6%, respectively. Conclusions: Dynamic MRI is useful for differentiating subtypes of small peripheral adenocarcinoma.