Lung cancer screening with MRI: results of the first screening round

• Published in: Journal of cancer research and clinical oncology Vol. 144; no. 1; pp. 117 - 125
• Main Authors: Meier-Schroers, Michael, Homsi, Rami, Skowasch, Dirk, Buermann, Jens, Zipfel, Matthias, Schild, Hans Heinz, Thomas, Daniel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2018; Springer Nature B.V
• Subjects: Biopsy; Cancer Research; Cancer screening; Carcinoma; Early Detection of Cancer - methods; Hematology; Humans; Internal Medicine; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lung nodules; Magnetic resonance imaging; Magnetic Resonance Imaging - instrumentation; Magnetic Resonance Imaging - methods; Medical screening; Medicine; Medicine & Public Health; Middle Aged; Multimodal Imaging - methods; Multimodal Imaging - mortality; Oncology; Original Article – Clinical Oncology; Original – Clinical Oncology; Tomography; Tomography, X-Ray Computed - instrumentation; Tomography, X-Ray Computed - methods; Screening; MRI; Lung cancer
• ISSN: 0171-5216; 1432-1335; 1432-1335
• DOI: 10.1007/s00432-017-2521-4

Purpose To evaluate the suitability of MRI for lung cancer screening in a high-risk population. Materials and methods A 5-year lung cancer screening program comparing MRI and low-dose CT (LDCT) in a high-risk population was initiated. 224 subjects were examined with MRI and LDCT. Acquired MRI sequences were T2w MultiVane XD, balanced steady-state-free precession, 3D T1w GRE, and DWI with a maximum in-room-time of 20 min. Categorization and management of nodules were based on Lung-RADS. MRI findings were correlated with LDCT as a reference. Here, we report on the first screening round. Results MRI accurately detected 61 of 88 nodules 4–5 mm, 20 of 21 nodules 6–7 mm, 12 of 12 nodules 8–14 mm, 4 of 4 nodules ≥ 15 mm (solid nodules), and 8 of 11 subsolid nodules. Sensitivity/specificity of MRI for nodule detection was 69.3/96.4% for 4–5 mm, 95.2/99.6% for 6–7 mm, 100/99.6% for 8–14 mm, 100/100% for ≥ 15 mm (solid nodules), and 72.7/99.2% for subsolid nodules. The early recall rate was 13.8% for MRI and 12.5% for LDCT. Following Lung-RADS recommendations and based on interdisciplinary consensus, histology was obtained in eight subjects. The biopsy rate was 3.6% for MRI and 3.4% for LDCT. In all of these eight cases, the nodules were carcinomas, and all of them were accurately detected by MRI. Conclusion The results of the first screening round suggest that MRI is suitable for lung cancer screening with an excellent sensitivity and specificity for nodules ≥ 6 mm.