Chest Wall Invasion by Peripheral Lung Cancer: Preoperative Assessment with Respiratory Dynamic MRI

Abstract

Purpose: The purpose of our study was to evaluate the usefulness of dynamic cine MRI during respiration in the assessment of chest wall invasion by lung cancer. Materials and Methods: We prospectively performed respiratory dynamic MRI in 34 patients with peripheral lung cancer, in whom the presence of chest wall invasion was indeterminate on CT. Sequential images were obtained during respiration by using fast spoiled GRASS (SPGR) sequence, and were analyzed in cine mode display. Results: In all 23 patients with free movement of the tumor along the chest wall on respiratory dynamic cine MRI, no chest wall invasion was found at surgery (negative predictive value 100%). In eleven patients with fixation of the tumor to the chest wall, invasion was confirmed pathologically in five patients, while benign fibrous adhesion was found in six. Conclusion: Although it has some limitations, dynamic cine MRI during respiration is useful in evaluating chest wall invasion in patients with lung cancer, particularly when CT findings are indeterminate.