Abstract
BackgroundRecent refinements of lung MRI techniques have reduced the examination time and improved diagnostic sensitivity and specificity. We conducted a study to assess the feasibility of MRI for the detection of primary lung cancer in asymptomatic individuals.MethodsA retrospective chart review was performed on images of lung parenchyma, which were extracted from whole-body MRI examinations between October 2000 and December 2007. 11,766 consecutive healthy individuals (mean age, 50.4 years; 56.8% male) were scanned using one of two 1.5-T scanners (Sonata and Sonata Maestro, Siemens Medical Solutions, Erlangen, Germany). The standard protocol included a quick whole-lung survey with T2-weighted 2-dimensional half Fourier acquisition single shot turbo spin echo (HASTE) and 3-dimensional volumetric interpolated breath-hold examination (VIBE). Total examination time was less than 10 minutes, and scanning time was only 5 minutes. Prompt referrals and follow-ups were arranged in cases of suspicious lung nodules.ResultsA total of 559 individuals (4.8%) had suspicious lung nodules. A total of 49 primary lung cancers were diagnosed in 46 individuals: 41 prevalence cancers and 8 incidence cancers. The overall detection rate of primary lung cancers was 0.4%. For smokers aged 51 to 70 years, the detection rate was 1.4%. TNM stage I disease accounted for 37 (75.5%). The mean size of detected lung cancers was 1.98 cm (median, 1.5 cm; range, 0.5-8.2 cm). The most histological types were adenocarcinoma in 38 (77.6%).ConclusionRapid zero-dose MRI can be used for lung cancer detection in a healthy population.
Highlights
Recent refinements of lung magnetic resonance imaging (MRI) techniques have reduced the examination time and improved diagnostic sensitivity and specificity
From October 2000 to December 2007, a total of 14,040 lung MRI examinations were performed in 11,766 consecutive individuals, who were asymptomatic and had no prior cancer history in the lung or elsewhere
If we calculate the results for smokers between 51 and 70 years old, as did the low-dose spiral computed tomography (LDCT) studies, the detection rate is 1.4% (6 of 434), and the prevalence of suspicious lung nodules is 9.0% (39 of 434)
Summary
Recent refinements of lung MRI techniques have reduced the examination time and improved diagnostic sensitivity and specificity. We conducted a study to assess the feasibility of MRI for the detection of primary lung cancer in asymptomatic individuals. Lung cancer is the leading cause of cancer death worldwide [1,2,3]. The overall 5-year survival rate is approximately 15% in the United States and less than 10% in Europe [4,5,6]. Because most lung cancers generate no symptoms at early stages, they are usually diagnosed at an advanced stage and have a poor prognosis. Many lung cancer deaths could be avoided if tumors were detected at an early stage when they were still resectable. For stage Ia non-small cell lung cancer, the 5-year survival rate is higher than 80%.
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