Spin-echo and diffusion-weighted MRI in differentiation between progressive massive fibrosis and lung cancer

Özet

PURPOSEWe aimed to investigate the value of magnetic resonance imaging (MRI)-based parameters indifferentiating between progressive massive fibrosis (PMF) and lung cancer.METHODSThis retrospective study included 60 male patients (mean age, 67.0±9.0 years) with a historyof more than 10 years working in underground coal mines who underwent 1.5 T MRI of thorax due to a lung nodule/mass suspicious for lung cancer on computed tomography. Thirtypatients had PMF, and the remaining ones had lung cancer diagnosed histopathologically.The sequences were as follows: coronal single-shot turbo spin echo (SSH-TSE), axial T1- andT2-weighted spin-echo (SE), balanced turbo field echo, T1-weighted high-resolution isotropic volume excitation, free-breathing and respiratory triggered diffusion-weighted imaging(DWI). The patients’ demographics, lesion sizes, and MRI‐derived parameters were comparedbetween the patients with PMF and lung cancer.RESULTSApparent diffusion coefficient (ADC) values of DWI and respiratory triggered DWI, signal intensities on T1-weighted SE, T2-weighted SE, and SSH-TSE imaging were found to be significantly different between the groups (p < 0.001, for all comparisons). Median ADC values offree-breathing DWI in patients with PMF and cancer were 1.25 (0.93–2.60) and 0.76 (0.53–1.00) (× 10-3 mm2/s), respectively. Most PMF lesions were predominantly iso- or hypointenseon T1-weighted SE, T2-weighted SE, and SSH-TSE, while most malignant ones predominantlyshowed high signal intensity on these sequences.CONCLUSIONMRI study including SE imaging, specially T1-weighted SE imaging and ADC values of DWI canhelp to distinguish PMF from lung cancer.