Evaluation of lung tumor perfusion by dynamic contrast-enhanced MRI

The characterization of solid pulmonary lesions with imaging methods remains a diagnostic challenge. The ann of this study was to correlate kinetic parameters of dynamic perfusion magnetic resonance imaging (MRI) with histological tumor classification. Dynamic contrast-enhanced MRI of 31 patients With pulmonary masses (five benign lesions, 26 malignant tumors) was acquired in the tumor areas every 20 s for a mean duration of 124 s. Contrast uptake (CU) was measured by signal analysis in re-ions of interest (ROIs). The beginning and duration of CU, maximum CU (MCU, % of baseline), maximum contrast upslope (%/s) and the delay to the maximum contrast upslope (s) were calculated. All lesions were classified histologically. The beginning of CU correlated significantly with the MCU delay in all lesions (P=.033). The frequency of a plateau phase was higher in malignant tumours compared to benign lesions (P=.031). Masses with a high MCU showed more frequently a washout of contrast Medium after a plateau phase (P=.006) and a higher maximum contrast upslope (P<.001). The MCU delay time was shorter in adenocarcinoma than in squamous cell carcinoma (P=.004). These results indicate that dynamic contrast enhanced MRI might become instrumental in differentiating benign from malignant intrapulmonary tumours and distinguishing adenocarcinoma from squamous cell carcinoma. (C) 2008 Elsevier Inc. All rights reserved.