• Gregor Sommer, Jan Tremper, Marcel Koenigkam-Santos, Stefan Delorme, Nikolaus Becker, Jürgen Biederer, Hans-Ulrich Kauczor, Claus Peter Heussel, Heinz-Peter Schlemmer, and Michael Puderbach.
• Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg, Germany; Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland. Electronic address: gregor.sommer@usb.ch.
• Eur J Radiol. 2014 Mar 1;83(3):600-5.

ObjectiveTo investigate the potential of MRI for lung nodule detection in a high-risk population in comparison to low-dose CT.Methods49 participants (31 men, 18 women, 51-71 years) of the German Lung Cancer Screening and Intervention Trial (LUSI) with a cancer-suspicious lung lesion in CT were examined with non-contrast-enhanced MRI of the lung at 1.5 T. Data were pseudonymized and presented at random order together with 30 datasets (23 in men, 7 in women, 18-64 years) from healthy volunteers. Two radiologists read the data for the presence of nodules. Sensitivity and specificity were calculated. Gold standard was either histology or long-term follow-up. Contrast-to-Noise-Ratio (CNR) was measured for all detected lesions in all MRI sequences.ResultsAverage maximum diameter of the lesions was 15 mm. Overall sensitivity and specificity of MRI were 48% (26/54) and 88% (29/33) compared to low-dose CT. Sensitivity of MRI was significantly higher for malignant nodules (78% (12.5/16)) than for benign ones (36% (13.5/38); P=0.007). There was no statistically significant difference in sensitivity between nodules (benign and malignant) larger or smaller than 10 mm (P=0.7). Inter observer agreement was 84% (κ=0.65). Lesion-to-background CNR of T2-weighted single-shot turbo-spin-echo was significantly higher for malignant nodules (89±27) than for benign ones (56±23; P=0.002).ConclusionThe sensitivity of MRI for detection of malignant pulmonary nodules in a high-risk population is 78%. Due to its inherent soft tissue contrast, MRI is more sensitive to malignant nodules than to benign ones. MRI may therefore represent a useful test for early detection of lung cancer.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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