A pilot study of native T1-mapping for focal pulmonary lesions in 3.0 T magnetic resonance imaging: size estimation and differential diagnosis

Shuyi Yang; Fei Shan; Qinqin Yan; Jie Shen; Peiyan Ye; Zhiyong Zhang; Yuxin Shi; Rengyin Zhang

doi:10.21037/jtd.2020.03.42

A pilot study of native T1-mapping for focal pulmonary lesions in 3.0 T magnetic resonance imaging: size estimation and differential diagnosis

J Thorac Dis. 2020 May;12(5):2517-2528. doi: 10.21037/jtd.2020.03.42.

Authors

Shuyi Yang¹, Fei Shan¹, Qinqin Yan¹, Jie Shen¹, Peiyan Ye², Zhiyong Zhang^{1

3}, Yuxin Shi¹, Rengyin Zhang¹

Affiliations

¹ Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
² Department of Hepatopathy, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
³ Fudan University, Shanghai 200433, China.

Abstract

Background: To investigate the accuracy of size estimation and potential diagnosis efficacy of native T1-mapping in focal pulmonary lesion, compared to T1-star 3D-volumetric interpolated breath-hold sequence (VIBE), T2-fBLADE turbo-spin echo (TSE), and computed tomography (CT).

Methods: Thirty-nine patients with CT-detected focal pulmonary lesions underwent thoracic 3.0-T magnetic resonance imaging (MRI) using axial free-breathing 3D T1-star VIBE, respiratory triggered T2-fBLADE TSE, breath-hold T1-Turbo fast low angle shot (FLASH) and T1-FLASH 3D. Native T1-mapping images were generated by T1-FLASH 3D with B1-filed correction by T1-Turbo FLASH. The intraclass correlation coefficient (ICC) and Bland-Altman plots were used to evaluate intra-observer agreement and inter-method reliability of diameter measurements. Native T1-values were measured and compared among the malignancy, tuberculosis, non-tuberculosis benign groups using Mann-Whitney U tests.

Results: Forty-five focal pulmonary lesions were displayed by CT, native T1-mapping, T1-star VIBE, and T2-fBLADE TSE. T1-mapping-based diameter measurements yielded an intra-observer ICC of 0.995. Additionally, inter-method measurements were highly consistent (T1-mapping & T1-star VIBE: ICC 0.982, T1-mapping & T2-fBLADE TSE: ICC 0.978, T1-mapping & CT: ICC 0.972). For lesions <3.00 cm, T1-mapping intra-observer (ICC 0.982) and inter-method diameter measurements were also highly consistent (T1-mapping & CT: ICC 0.823). Native T1-values of malignant tumors were lower than those of the non-tuberculosis benign lesions (P=0.003). Native T1-values of tuberculosis were lower than those of the non-tuberculosis benign lesions (P=0.002). Native T1-values showed no statistically significant differences between malignant tumors and tuberculosis (P=0.059).

Conclusions: Native T1-mapping enable accurate and reliable diameter measurement. Native T1-values potentially differentiate malignant tumors or tuberculosis from non-tuberculosis benign lesions.

Keywords: Pulmonary cancer; T1-mapping; magnetic resonance imaging (MRI); pulmonary tuberculosis.