Diagnostic and Interventional Radiology
Chest Imaging - Original Article

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


Department of Radiology, Koc University, Istanbul, Turkey


Department of Pulmonology, Bulent Ecevit University, Zonguldak, Turkey


Department of Public Health, Ege University, Izmir, Turkey


Department of Radiology, Ege University, Izmir, Turkey

Diagn Interv Radiol 2020; 1: -
Read: 821 Published: 14 July 2020

PURPOSE: We aimed to investigate the correlation of MRI-based parameters between the patients with progressive massive fibrosis (PMF) and lung cancer.

METHODS: This retrospective study included 60 male patients (mean age, 67.0 ± 9.0 years) with a working history of more than 10 years in coal mines who underwent 1.5T MRI of thorax due to a lung nodule/mass suspicious for lung cancer on computed tomography. Thirty patients 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- and T2-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 compared between the patients with PMF and lung cancer, using Student’s t, Mann Whitney U, and Pearson’s chi-square tests.

RESULTS: Apparent diffusion coefficient (ADC) values of DWI and respiratory triggered DWI, signal intensities on T1W SE, T2W SE, and SSH-TSE imaging were found to be significant between the groups (P < 0.001, for all comparisons).  Median ADC values of free-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 of PMF lesions were predominantly iso- or hypointense on T1-weighted SE, T2-weighted SE, and SSH-TSE, while most of malignant ones predominantly showed high signal intensity on these sequences.

CONCLUSION: A noninvasive MRI study including SE imaging, specially T1-weighted SE imaging and ADC values of DWI can help to distinguish PMF from lung cancer.

EISSN 1305-3612