Monitoring of Lung Motion in Patients With Malignant Pleural Mesothelioma Using Two-Dimensional and Three-Dimensional Dynamic Magnetic Resonance Imaging: Comparison With Spirometry

Investigative Radiology. 2006 May;41(5):443-448. [Link]

Plathow C, Klopp M, Schoebinger M, Thieke C, Fink C, Puderbach M, Ley S, Weber MA, Sandner A, Claussen CD, Herth F, Tuengerthal S, Meinzer HP, Kauczor HU.

From the Department of Diagnostic Radiology, Eberhard-Karls University, Tuebingen, Germany; Department of Radiology, Department of Medical and Biological Informatics, and Department of Radiation Oncology, German Cancer Research Center Heidelberg, Germany; Department of Pneumology, Department of Oncology, Department of Radiology, Clinic for Thoracic Disease, and Department of Thoracic Surgery, Heidelberg, Germany; and Department of Radiology, Ludwig-Maximilian University of Munich, Germany.


Purpose: To monitor lung motion in patients with malignant pleural mesothelioma (MPM) before and after chemotherapy (CHT) using 2-dimensional (2D) and 3-dimensional (3D) dynamic MRI (dMRI) in comparison with spirometry.

Methods and Materials: Twenty-two patients with MPM were examined before CHT, as well as after 3 and 6 CHT cycles (3 months and 6 months) using 2D dMRI (trueFISP; 3 images/s) and 3D dMRI (FLASH 3D, 1 slab (52 slices)/s) using parallel imaging in combination with view-sharing technique. Maximum craniocaudal lung dimensions (2D) and lung volumes (3D) were monitored, separated into the tumor-bearing and nontumor-bearing hemithorax. Vital capacity (VC) was measured for comparison using spirometry.

Results: Using 2D technique, there was a significant difference between the tumor-bearing and the nontumor-bearing hemithorax before CHT (P < 0.01) and after 3 CHT cycles (P < 0.05), whereas difference was not significant in the second control. In the tumor-bearing hemithorax, mobility increased significantly from the status before versus after 3 CHT cycles (4.1 +/- 1.1 cm vs. 4.8 +/- 1.4 cm, P < 0.05). Using 3D technique, at maximum inspiration, the volume of the tumor-bearing hemithorax was 0.6 +/- 0.4 L and of the nontumor-bearing hemithorax 1.25 +/- 0.4 L before CHT. In the follow-up exams, these volumes changed to 1.05 +/- 0.4 L (P < 0.05) and 1.4 +/- 0.5 L, respectively. Using spirometry, there was no significant change in VC (1.9 +/- 0.4 L vs. 2.2 +/- 0.7 L vs. 2.2 +/- 0.9 L).

Conclusions: dMRI is capable of monitoring changes in lung motion and volumetry in patients with MPM not detected by global spirometry. Thus, dMRI is proposed for use as a further measure of therapy response.