A comparison between MRI and CT in the assessment of primary tumour volume in mesothelioma

Tsim, S., Cowell, G. W., Kidd, A., Woodward, R., Alexander, L., Kelly, C. , Foster, J. E. and Blyth, K. G. (2020) A comparison between MRI and CT in the assessment of primary tumour volume in mesothelioma. Lung Cancer, 150, pp. 12-20. (doi: 10.1016/j.lungcan.2020.09.025) (PMID:33039775)

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Abstract

Primary tumour staging in Malignant Pleural Mesothelioma (MPM) using Computed Tomography (CT) imaging is confounded by perception errors reflecting low spatial resolution between tumour and adjacent structures. Augmentation using perfusion CT is constrained by radiation dosage. In this study, we evaluated an alternative tumour staging method using perfusion-tuned Magnetic Resonance Imaging (MRI). Consecutive patients with suspected MPM were recruited to a prospective observational study. All had MRI (T1-weighted, isotropic, contrast-enhanced 3-Tesla perfusion imaging) and CT (contrast-enhanced) pre-biopsy. Patients diagnosed with MPM underwent MRI and CT volumetry, with readers blinded to clinical data. MRI volumetry was semi-automated, using signal intensity limits from perfusion studies to grow tumour regions within a pleural volume. A similar CT method was not possible, therefore all visible tumour was manually segmented. MRI and CT volumes were compared (agreement, correlation, analysis time, reproducibility) and associations with survival examined using Cox regression. 58 patients were recruited and had MRI before biopsy. 31/58 were diagnosed with MPM and these scans were used for volumetry. Mean (SD) MRI and CT volumes were 370 cm and 302 cm , respectively. MRI volumes were larger (average bias 61.9 cm (SD 116), 95 % limits (-165.5 - 289 cm ), moderately correlated with CT (r = 0.56, p = 0.002) and independently associated with survival (HR 4.03 (95 % CI 1.5-11.55), p = 0.006). CT volumes were not associated with survival, took longer to compute than MRI volumes (mean (SD) 151 (19) v 14 (2) minutes, p=<0.0001) and were less reproducible (inter-observer ICC 0.72 for CT, 0.96 for MRI). MRI and CT generate different tumour volumes in MPM. In this study, MRI volumes were larger and were independently associated with survival. MRI volumetry was quicker and more reproducible than CT.

Item Type:Articles
Additional Information:This research was supported by funding provided by the Chief Scientist Office Scotland, grant number ETM/285.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Foster, Dr John and Cowell, Dr Gordon and Blyth, Professor Kevin and Alexander, Mrs Laura and Tsim, Dr Selina and Kelly, Mrs Caroline and Kidd, Mr Andrew and Woodward, Miss Rosemary
Creator Roles:
Tsim, S.Data curation, Formal analysis, Investigation, Methodology, Software, Validation, Visualization, Writing – original draft, Writing – review and editing
Cowell, G.Formal analysis, Methodology, Software, Validation, Visualization, Writing – review and editing
Kidd, A.Formal analysis, Methodology, Software, Validation, Visualization, Writing – review and editing
Woodward, R.Investigation, Methodology, Resources, Software, Supervision, Validation, Visualization, Writing – review and editing
Alexander, L.Data curation, Project administration, Resources, Validation, Writing – review and editing
Kelly, C.Data curation, Formal analysis, Funding acquisition, Methodology, Resources, Software, Supervision, Validation, Writing – review and editing
Foster, J.Formal analysis, Funding acquisition, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing – review and editing
Blyth, K.Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review and editing
Authors: Tsim, S., Cowell, G. W., Kidd, A., Woodward, R., Alexander, L., Kelly, C., Foster, J. E., and Blyth, K. G.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
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:01 October 2020
Copyright Holders:Copyright © 2020 Elsevier B.V.
First Published:First published in Lung Cancer 150:12-20
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
168769An examination of diagnostic and prognostic biomarkers in malignant pleural mesotheliomaKevin BlythOffice of the Chief Scientific Adviser (CSO)ETM/285CS - Clinical Research Garscube