Gadolinium-Based Blood Volume Mapping From MRI With Ultrashort TE Versus CT and SPECT for Predicting Postoperative Lung Function in Patients With Non-Small Cell Lung Cancer.

Abstract

The purpose of this study is to directly compare the capability of gadolinium-based blood volume (BV) mapping from MRI (BV-MRI) with ultrashort TE (UTE) with that of CT and perfusion SPECT in predicting the postoperative lung function of patients with non-small cell lung cancer (NSCLC). Unenhanced and contrast-enhanced MRI with UTE, thin-section CT, and perfusion SPECT examinations and measurements of the percentage of forced expiratory volume in 1 second (FEV₁) before and after lung resection were performed for 29 patients with NSCLC (16 men [mean age, 66 years] and 13 women [mean age, 66 years]). BV-MRI with UTE was generated as a percentage of the signal change between unenhanced and contrast-enhanced MRI. The postoperative percentage of FEV₁ was predicted from perfusion fractions derived from BV-MRI with UTE and from SPECT. Quantitatively and qualitatively predicted postoperative percentages of FEV₁ from CT were calculated from the functional lung volumes and the number of segments. Each predicted postoperative percentage of FEV₁ was then correlated with the actual postoperative percentage of FEV₁, and the limits of agreement for each actual and predicted postoperative percentage of FEV₁ were evaluated by Bland-Altman analysis. Correlations between actual and predicted postoperative percentages of FEV₁ for all methods were strong and significant (0.88 ≤ r ≤ 0.95). The limits of agreement (mean ± 1.96 × SD) for BV-MRI with UTE (4.2% ± 6.5%) and quantitatively assessed CT (4.1% ± 6.5%) were smaller than those for qualitatively assessed CT (4.2% ± 9.8%) and perfusion SPECT (5.7% ± 8.7%). BV-MRI with UTE has the potential to predict the postoperative lung function of patients with NSCLC more accurately than qualitatively assessed CT and SPECT, and it can be considered to be at least as useful as quantitatively assessed CT.