Diagnostic and Interventional Radiology
Chest Imaging - Original Article

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

1.

Department of Radiology, Koc University, Istanbul, Turkey

2.

Department of Pulmonology, Bulent Ecevit University, Zonguldak, Turkey

3.

Department of Public Health, Ege University, Izmir, Turkey

4.

Department of Radiology, Ege University, Izmir, Turkey

Diagn Interv Radiol 2021; 27: 469-475
DOI: 10.5152/dir.2021.20344
Read: 544 Downloads: 52 Published: 22 June 2021

PURPOSE 
We aimed to investigate the value of magnetic resonance imaging (MRI)-based parameters in differentiating between progressive massive fibrosis (PMF) and lung cancer.

METHODS
This retrospective study included 60 male patients (mean age, 67.0±9.0 years) with a history of more than 10 years working in underground coal mines who underwent 1.5 T 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.

RESULTS
Apparent diffusion coefficient (ADC) values of DWI and respiratory triggered DWI, signal intensities on T1-weighted SE, T2-weighted SE, and SSH-TSE imaging were found to be significantly different 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 PMF lesions were predominantly iso- or hypointense on T1-weighted SE, T2-weighted SE, and SSH-TSE, while most malignant ones predominantly showed high signal intensity on these sequences. 

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

You may cite this article as: Guneyli S, Tor M, Hassoy H, et al. Spin-echo and diffusion-weighted MRI in differentiation between progressive massive fibrosis and lung cancer. Diagn Interv Radiol 2021; 27:469-475
 

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