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

Plathow, Christian MD, MSc*†; Klopp, Michael MD††; Schoebinger, Max MSc‡; Thieke, Christian MD, PhD§; Fink, Christian MD†§§; Puderbach, Michael MD†; Ley, Sebastian MD†; Weber, Marc-Andre MD, MSc†; Sandner, Alexandra MD¶; Claussen, Claus D. MD*; Herth, Felix MD∥; Tuengerthal, Siegfried MD**; Meinzer, Hans-Peter MSc, PhD**; Kauczor, Hans-Ulrich MD†

doi: 10.1097/01.rli.0000208222.03256.ba
Original Article

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).

Conclusion: 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.

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.

Received October 13, 2005, and accepted for publication, after revision, December 9, 2005.

Reprints: Christian Plathow, MD, MSc, Department of Diagnostic Radiology, Eberhard-Kalrs University, Hoppe-Seyler 3, 72076 Tuebingen; E-mail: christian.plathow@med.uni-tuebingen.de.

© 2006 Lippincott Williams & Wilkins, Inc.