Current pulmonary nodule guidelines do not include MRI in the management algorithms for incidental pulmonary nodules [2,9]. MRI Chest Without and With IV Contrast There is no relevant literature to support the use of dynamic MRI chest in the evaluation of incidentally detected indeterminate pulmonary nodules. MRI has been increasingly studied as an alternative method in the evaluation of incidental pulmonary nodules over the last decades, with reported sensitivities ranging from 26% to 96% for various MRI sequences [54]. Major limitations for accurate nodule characterization include artifact from respiratory and cardiac motion and poor image contrast in lung MRI, which are addressed on the MRI Chest Without IV Contrast section. Similar to dynamic contrast-enhanced CT, dynamic MRI techniques have been proposed to differentiate benign from malignant pulmonary nodules. Reported sensitivities range from 52% to 100%, specificities from 17% to 100%, and accuracies from 58% to 96% [54,64]. Factors contributing to the wide ranges include variable study design, different sequences studied, and lower performance in cohorts living in areas with high prevalence of active infection. The authors have looked into improving the performance of dynamic contrast-enhanced MRI by adding semiquantitative analysis [65] or combining it with additional sequences, with a small series showing improved specificity and minimal improved accuracy in differentiating benign from malignant solitary nodules [54,66]. Incidentally Detected Indeterminate Pulmonary Nodule Overall, MRI might have a future role as a complementary tool in the stratification of incidental pulmonary nodules, possibly multiparametric MRI, but further research and validation studies are required before MRI is implemented in clinical practice. Current pulmonary nodule guidelines do not include MRI in the management algorithms for incidental pulmonary nodules [2,9].
Incidentally Detected Indeterminate Pulmonary Nodule PCAs. Current pulmonary nodule guidelines do not include MRI in the management algorithms for incidental pulmonary nodules [2,9]. MRI Chest Without and With IV Contrast There is no relevant literature to support the use of dynamic MRI chest in the evaluation of incidentally detected indeterminate pulmonary nodules. MRI has been increasingly studied as an alternative method in the evaluation of incidental pulmonary nodules over the last decades, with reported sensitivities ranging from 26% to 96% for various MRI sequences [54]. Major limitations for accurate nodule characterization include artifact from respiratory and cardiac motion and poor image contrast in lung MRI, which are addressed on the MRI Chest Without IV Contrast section. Similar to dynamic contrast-enhanced CT, dynamic MRI techniques have been proposed to differentiate benign from malignant pulmonary nodules. Reported sensitivities range from 52% to 100%, specificities from 17% to 100%, and accuracies from 58% to 96% [54,64]. Factors contributing to the wide ranges include variable study design, different sequences studied, and lower performance in cohorts living in areas with high prevalence of active infection. The authors have looked into improving the performance of dynamic contrast-enhanced MRI by adding semiquantitative analysis [65] or combining it with additional sequences, with a small series showing improved specificity and minimal improved accuracy in differentiating benign from malignant solitary nodules [54,66]. Incidentally Detected Indeterminate Pulmonary Nodule Overall, MRI might have a future role as a complementary tool in the stratification of incidental pulmonary nodules, possibly multiparametric MRI, but further research and validation studies are required before MRI is implemented in clinical practice. Current pulmonary nodule guidelines do not include MRI in the management algorithms for incidental pulmonary nodules [2,9].