Early Contrast Enhancement: a novel Magnetic Resonance Imaging biomarker of pleural malignancy

Tsim, S. et al. (2018) Early Contrast Enhancement: a novel Magnetic Resonance Imaging biomarker of pleural malignancy. Lung Cancer, 118, pp. 48-56. (doi: 10.1016/j.lungcan.2018.01.014) (PMID:29572002) (PMCID:PMC5884311)

[img]
Preview
Text
156641.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

779kB

Abstract

Introduction: Pleural Malignancy (PM) is often occult on subjective radiological assessment. We sought to define a novel, semi-objective Magnetic Resonance Imaging (MRI) biomarker of PM, targeted to increased tumour microvessel density (MVD) and applicable to minimal pleural thickening. Materials and methods: 60 consecutive patients with suspected PM underwent contrast-enhanced 3-T MRI then pleural biopsy. In 58/60, parietal pleura signal intensity (SI) was measured in multiple regions of interest (ROI) at multiple time-points, generating ROI SI/time curves and Mean SI gradient (MSIG: SI increment/time). The diagnostic performance of Early Contrast Enhancement (ECE; which was defined as a SI peak in at least one ROI at or before 4.5 min) was compared with subjective MRI and Computed Tomography (CT) morphology results. MSIG was correlated against tumour MVD (based on Factor VIII immunostain) in 31 patients with Mesothelioma. Results: 71% (41/58) patients had PM. Pleural thickening was <10 mm in 49/58 (84%). ECE sensitivity was 83% (95% CI 61–94%), specificity 83% (95% CI 68–91%), positive predictive value 68% (95% CI 47–84%), negative predictive value 92% (78–97%). ECE performance was similar or superior to subjective CT and MRI. MSIG correlated with MVD (r = 0.4258, p = .02). Discussion: ECE is a semi-objective, perfusion-based biomarker of PM, measurable in minimal pleural thickening. Further studies are warranted.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Dick, Dr Craig and Tsim, Dr Selina and Foster, Dr John and Kelly, Mrs Caroline and Blyth, Professor Kevin and Alexander, Mrs Laura and Woodward, Miss Rosemary
Authors: Tsim, S., Humphreys, C. A., Cowell, G. W., Stobo, D. B., Noble, C., Woodward, R., Kelly, C. A., Alexander, L., Foster, J. E., Dick, C., and Blyth, K. G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Lung Cancer
Publisher:Elsevier
ISSN:0169-5002
ISSN (Online):1872-8332
Published Online:03 February 2018
Copyright Holders:Copyright © 2018 Elsevier B.V.
First Published:First published in Lung Cancer 118:48-56
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record

Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
648131An examination of diagnostic and prognostic biomarkers in malignant pleural mesotheliomaKevin BlythChief Scientist office (CSO)ETM/285SCHOOL OF MEDICINE, DENTISTRY & NURSING