Quantitative imaging in medicine and surgery · 2026
Performance of free-breathing contrast-enhanced and unenhanced stack-of-spirals ultrashort echo time MRI for lung follow-up in patients with malignancies at 1.5T.
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Wu Jia-Wei, Sun Xin, Li Zi-Kai, Meng Xue-Ni, Li Qian, Xiao Ao-Dong, Yin Ting, Benkert Thomas, Sun Peng, Lu Hao-Hao, Fu Qing
Аннотация
BACKGROUND: Stack-of-spirals ultrashort echo time (spiral-UTE) has been reported to be feasible for lung imaging; however, the performance of free-breathing contrast-enhanced and unenhanced spiral-UTE (UTEe and UTEu) is still unknown. Therefore, this study aimed to evaluate their performance of lung imaging in patients with malignant tumors.
METHODS: A total of 76 patients with malignancies suspected of pulmonary metastatic nodules were enrolled in free-breathing UTEe, UTEu and routine contrast-enhanced T1-weighted imaging [volumetric interpolated breath-hold examination (VIBE)] for lung follow-up. Two radiologists independently assessed the image quality, and qualitative analysis was scored via a 5-point scale (4, excellent; 0, unreadable) with respect to the visibility of fissures, airways and vessels; signal homogeneity; motion artifacts; lesion conspicuity; and overall image quality. Quantitative analysis included measurements of the apparent contrast-to-noise ratio (CNR) and apparent signal-to-noise ratio (SNR). Pulmonary nodules detected via magnetic resonance (MR) images were compared with those by computed tomography (CT) as the reference standard.
RESULTS: Both UTEu and UTEe outperformed VIBE in all the qualitative metrics (P<0.001) and there was no significant difference between UTEu and UTEe (P>0.05) in those metrics. UTEe exhibited the best performance in depicting pulmonary vessels, achieving the highest apparent SNR and apparent CNR values. Among the 130 pulmonary nodules identified via CT, spiral-UTE had a sensitivity of 76.9% and a positive predictive value (PPV) of 99.0%, significantly outperforming VIBE (sensitivity of 47.7% and PPV of 95.4%). The detection rates for spiral-UTE were 90.0% for nodules larger than 5 mm, 98.5% for nodules larger than 7 mm and 100.0% for nodules larger than 10 mm.
CONCLUSIONS: Spiral-UTE demonstrated superior image quality and greater sensitivity for pulmonary nodule detection than breath-hold VIBE did. Both unenhanced and enhanced spiral-UTE showed comparable performance in nodule detection, highlighting its potential as a reliable imaging modality for patients with malignant tumors during follow-up imaging.
METHODS: A total of 76 patients with malignancies suspected of pulmonary metastatic nodules were enrolled in free-breathing UTEe, UTEu and routine contrast-enhanced T1-weighted imaging [volumetric interpolated breath-hold examination (VIBE)] for lung follow-up. Two radiologists independently assessed the image quality, and qualitative analysis was scored via a 5-point scale (4, excellent; 0, unreadable) with respect to the visibility of fissures, airways and vessels; signal homogeneity; motion artifacts; lesion conspicuity; and overall image quality. Quantitative analysis included measurements of the apparent contrast-to-noise ratio (CNR) and apparent signal-to-noise ratio (SNR). Pulmonary nodules detected via magnetic resonance (MR) images were compared with those by computed tomography (CT) as the reference standard.
RESULTS: Both UTEu and UTEe outperformed VIBE in all the qualitative metrics (P<0.001) and there was no significant difference between UTEu and UTEe (P>0.05) in those metrics. UTEe exhibited the best performance in depicting pulmonary vessels, achieving the highest apparent SNR and apparent CNR values. Among the 130 pulmonary nodules identified via CT, spiral-UTE had a sensitivity of 76.9% and a positive predictive value (PPV) of 99.0%, significantly outperforming VIBE (sensitivity of 47.7% and PPV of 95.4%). The detection rates for spiral-UTE were 90.0% for nodules larger than 5 mm, 98.5% for nodules larger than 7 mm and 100.0% for nodules larger than 10 mm.
CONCLUSIONS: Spiral-UTE demonstrated superior image quality and greater sensitivity for pulmonary nodule detection than breath-hold VIBE did. Both unenhanced and enhanced spiral-UTE showed comparable performance in nodule detection, highlighting its potential as a reliable imaging modality for patients with malignant tumors during follow-up imaging.