Korean Journal of Radiology

  • 제22권5호
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  • Pages.829-839
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  • 2021
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Imaging Assessment of Visceral Pleural Surface Invasion by Lung Cancer: Comparison of CT and Contrast-Enhanced Radial T1-Weighted Gradient Echo 3-Tesla MRI

  • Yu Zhang (Department of Radiology, Yonsei University Wonju College of Medicine) ;
  • Woocheol Kwon (Department of Diagnostic Radiology, College of Medicine, Ewha Womans University) ;
  • Ho Yun Lee (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung Min Ko (Department of Radiology, Yonsei University Wonju College of Medicine) ;
  • Sang-Ha Kim (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Won-Yeon Lee (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Suk Joong Yong (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Soon-Hee Jung (Department of Pathology, Yonsei University Wonju College of Medicine) ;
  • Chun Sung Byun (Department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine) ;
  • JunHyeok Lee (Department of Biostatistics, Yonsei University Wonju College of Medicine) ;
  • Honglei Yang (Department of Radiology, Yonsei University Wonju College of Medicine) ;
  • Junhee Han (Department of Radiology, Yonsei University Wonju College of Medicine) ;
  • Jeanne B. Ackman (Harvard Medical School, Massachusetts General Hospital)
  • 투고 : 2020.07.27
  • 심사 : 2020.11.28
  • 발행 : 2021.05.01
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초록

Objective: To compare the diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3-tesla (3T) magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of visceral pleural surface invasion (VPSI). Visceral pleural invasion by non-small-cell lung cancer (NSCLC) can be classified into two types: PL1 (without VPSI), invasion of the elastic layer of the visceral pleura without reaching the visceral pleural surface, and PL2 (with VPSI), full invasion of the visceral pleura. Materials and Methods: Thirty-three patients with pathologically confirmed VPSI by NSCLC were retrospectively reviewed. Multidetector CT and contrast-enhanced 3T MRI with a free-breathing radial three-dimensional fat-suppressed volumetric interpolated breath-hold examination (VIBE) pulse sequence were compared in terms of the length of contact, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. Supplemental evaluation of the tumor-pleura interface (smooth versus irregular) could only be performed with MRI (not discernible on CT). Results: At the tumor-pleura interface, radial VIBE MRI revealed a smooth margin in 20 of 21 patients without VPSI and an irregular margin in 10 of 12 patients with VPSI, yielding an accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F-score for VPSI detection of 91%, 83%, 95%, 91%, 91%, and 87%, respectively. The McNemar test and receiver operating characteristics curve analysis revealed no significant differences between the diagnostic accuracies of CT and MRI for evaluating the contact length, angle of mass margin, or arch distance-to-maximum tumor diameter ratio as predictors of VPSI. Conclusion: The diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3T MRI and CT were equal in terms of the contact length, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. The advantage of MRI is its clear depiction of the tumor-pleura interface margin, facilitating VPSI detection.

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참고문헌

  1. Chang YL, Lin MW, Shih JY, Wu CT, Lee YC. The significance of visceral pleural surface invasion in 321 cases of non-small cell lung cancers with pleural retraction. Ann Surg Oncol 2012;19:3057-3064
  2. Feng SH, Yang ST. The new 8th TNM staging system of lung cancer and its potential imaging interpretation pitfalls and limitations with CT image demonstrations. Diagn Interv Radiol 2019;25:270-279
  3. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 2016;11:39-51
  4. Sakakura N, Mori S, Okuda K, Fukui T, Hatooka S, Shinoda M, et al. Subcategorization of lung cancer based on tumor size and degree of visceral pleural invasion. Ann Thorac Surg 2008;86:1084-1090
  5. Glazer HS, Duncan-Meyer J, Aronberg DJ, Moran JF, Levitt RG, Sagel SS. Pleural and chest wall invasion in bronchogenic carcinoma: CT evaluation. Radiology 1985;157:191-194
  6. Ebara K, Takashima S, Jiang B, Numasaki H, Fujino M, Tomita Y, et al. Pleural invasion by peripheral lung cancer: prediction with three-dimensional CT. Acad Radiol 2015;22:310-319
  7. Hsu JS, Han IT, Tsai TH, Lin SF, Jaw TS, Liu GC, et al. Pleural tags on CT scans to predict visceral pleural invasion of non-small cell lung cancer that does not abut the pleura. Radiology 2016;279:590-596
  8. Hsu JS, Jaw TS, Yang CJ, Lin SF, Shih MP, Chou SH, et al. Convex border of peripheral non-small cell lung cancer on CT images as a potential indicator of pleural invasion. Medicine (Baltimore) 2017;96:e7323
  9. Cho HH, Choi YH, Cheon JE, Lee SM, Kim WS, Kim IO, et al. Free-breathing radial 3D fat-suppressed T1-weighted gradient-echo sequence for contrast-enhanced pediatric spinal imaging: comparison with T1-weighted turbo spin-echo sequence. AJR Am J Roentgenol 2016;207:177-182
  10. Zhang F, Qu J, Zhang H, Liu H, Qin J, Ding Z, et al. Preoperative T staging of potentially resectable esophageal cancer: a comparison between free-breathing radial VIBE and breath-hold Cartesian VIBE, with Histopathological correlation. Transl Oncol 2017;10:324-331
  11. Lee H, Choi E, Lee MK, Zhang Y, Kwon W. Morphologic evaluation of primary non-small cell lung cancer by 3 tesla MRI with free-breathing ultrashort echo time and radial T1- weighted gradient echo sequences: a comparison with CT analysis. J Korean Soc Radiol 2019;80:466-476
  12. Herman SJ, Winton TL, Weisbrod GL, Towers MJ, Mentzer SJ. Mediastinal invasion by bronchogenic carcinoma: CT signs. Radiology 1994;190:841-846
  13. Glazer HS, Kaiser LR, Anderson DJ, Molina PL, Emami B, Roper CL, et al. Indeterminate mediastinal invasion in bronchogenic carcinoma: CT evaluation. Radiology 1989;173:37-42
  14. Imai K, Minamiya Y, Ishiyama K, Hashimoto M, Saito H, Motoyama S, et al. Use of CT to evaluate pleural invasion in non-small cell lung cancer: measurement of the ratio of the interface between tumor and neighboring structures to maximum tumor diameter. Radiology 2013;267:619-626
  15. Travis WD, Brambilla E, Rami-Porta R, Vallieres E, Tsuboi M, Rusch V, et al. Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer. J Thorac Oncol 2008;3:1384-1390
  16. Kundel HL, Polansky M. Measurement of observer agreement. Radiology 2003;228:303-308
  17. Bai JH, Hsieh MS, Liao HC, Lin MW, Chen JS. Prediction of pleural invasion using different imaging tools in non-small cell lung cancer. Ann Transl Med 2019;7:33
  18. Akata S, Kajiwara N, Park J, Yoshimura M, Kakizaki D, Abe K, et al. Evaluation of chest wall invasion by lung cancer using respiratory dynamic MRI. J Med Imaging Radiat Oncol 2008;52:36-39
  19. Tsuchiya N, Doai M, Usuda K, Uramoto H, Tonami H. Nonsmall cell lung cancer: whole-lesion histogram analysis of the apparent diffusion coefficient for assessment of tumor grade, lymphovascular invasion and pleural invasion. PLoS One 2017;12:e0172433
  20. Warth A, Muley T, Herpel E, Pfannschmidt J, Hoffmann H, Dienemann H, et al. A histochemical approach to the diagnosis of visceral pleural infiltration by non-small cell lung cancer. Pathol Oncol Res 2010;16:119-123
  21. Gallagher B, Urbanski SJ. The significance of pleural elastica invasion by lung carcinomas. Hum Pathol 1990;21:512-517
  22. Shiotani S, Sugimura K, Sugihara M, Kawamitsu H, Yamauchi M, Yoshida M, et al. Diagnosis of chest wall invasion by lung cancer: useful criteria for exclusion of the possibility of chest wall invasion with MR imaging. Radiat Med 2000;18:283-290
  23. Murata K, Takahashi M, Mori M, Shimoyama K, Mishina A, Fujino S, et al. Chest wall and mediastinal invasion by lung cancer: evaluation with multisection expiratory dynamic CT. Radiology 1994;191:251-255
  24. Suzuki N, Saitoh T, Kitamura S. Tumor invasion of the chest wall in lung cancer: diagnosis with US. Radiology 1993;187:39-42
  25. Yokoi K, Mori K, Miyazawa N, Saito Y, Okuyama A, Sasagawa M. Tumor invasion of the chest wall and mediastinum in lung cancer: evaluation with pneumothorax CT. Radiology 1991;181:147-152
  26. Kajiwara N, Akata S, Uchida O, Usuda J, Ohira T, Kawate N, et al. Cine MRI enables better therapeutic planning than CT in cases of possible lung cancer chest wall invasion. Lung Cancer 2010;69:203-208