Diagnostic Performance and Reliability of Non-Enhanced Imaging Characterization Quotients for the Differentiation of Infectious and Malignant Pulmonary Nodules in Hematological Patients Using 3T MRI

To evaluate the diagnostic performance and reliability of non-enhanced imaging characterization quotients (NICQs) derived from magnetic resonance imaging (MRI) in the differential diagnosis of pulmonary nodules in hematological patients. A total of 83 lesions in 45 consecutive hematological patient...

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Published in:	RöFo : Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebende Verfahren Vol. 192; no. 4; p. 327
Main Authors:	Nagel, Sebastian Niko, Kim, Damon, Wylutzki, Tatjana, Steffen, Ingo G, Schwartz, Stefan, Penzkofer, Tobias, Hamm, Bernd, Elgeti, Thomas
Format:	Journal Article
Language:	English
Published:	Germany 01-04-2020
Subjects:	Adult Aged Diagnosis, Differential Female Hematologic Diseases - diagnostic imaging Humans Image Enhancement Lung Diseases, Fungal - diagnostic imaging Lung Neoplasms - diagnostic imaging Lymphoma - diagnostic imaging Magnetic Resonance Imaging Male Middle Aged Multiple Pulmonary Nodules - diagnostic imaging Pneumonia - diagnostic imaging Pneumonia, Bacterial - diagnostic imaging Reproducibility of Results Solitary Pulmonary Nodule - diagnostic imaging
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Summary:	To evaluate the diagnostic performance and reliability of non-enhanced imaging characterization quotients (NICQs) derived from magnetic resonance imaging (MRI) in the differential diagnosis of pulmonary nodules in hematological patients. A total of 83 lesions in 45 consecutive hematological patients were analyzed (10 bacterial pneumonias, 16 fungal pneumonias, 19 pulmonary lymphoma manifestations). The MRI protocol included T2-weighted single-shot fast spin echo (FSE) and T1-weighted gradient echo (GRE) sequences. T2-based T2-NICQ and T2-NICQ were calculated from signal intensities measured in the lesion, muscle, and fat ((SI - SI )/(SI - SI ) * 100), and simple T1-based T1-Q from signal intensities of the lesion and muscle (SI /SI ). Images were read by one radiologist with > 7 years and one with 1 year of experience. For statistical evaluation the Kruskal-Wallis or Mann-Whitney U-test, receiver operating characteristic (ROC) analysis with calculation of areas under the curve (AUC), and intraclass correlation coefficients (ICCs) were used. Medians of T2-NICQs differed significantly when comparing infectious lesions and lymphoma manifestations in general (T2-NICQ 20.33 vs. 10.14; T2-NICQ 34.96 vs. 25.52) or fungal lesions and lymphoma manifestations in particular (T2-NICQ 19.00 vs. 10.14; T2-NICQ 34.49 vs. 25.25). The AUCs for T2-NICQs on the per-patient level ranged from 0.73 to 0.79. ICCs were at least > 0.85, except for intrarater testing of T2-NICQ (0.79). The overall diagnostic performance of T2-NICQs is adequate for differentiating infectious and fungal lesions from lymphoma manifestations. The results show good to excellent intra- and interrater agreement. We therefore consider NICQs helpful in the diagnostic workup of pulmonary nodules in hematological patients. · Non-enhanced Imaging Characterization Quotients provide a fast and pragmatic approach for assessing pulmonary lesions in hematological patients.. · The diagnostic performance of Non-enhanced Imaging Characterization Quotients is adequate for differentiating infectious and fungal infiltrates from lymphoma manifestations.. · Non-enhanced Imaging Characterization Quotients show good to excellent intra- and interrater agreement.. · Nagel SN, Kim D, Wylutzki T et al. Diagnostic Performance and Reliability of Non-Enhanced Imaging Characterization Quotients for the Differentiation of Infectious and Malignant Pulmonary Nodules in Hematological Patients Using 3T MRI. Fortschr Röntgenstr 2020; 192: 327 - 334.
ISSN:	1438-9010
DOI:	10.1055/a-1005-7424