MR in Staging Lung Cancer
With the exception of assessment for chest wall invasion, MR imaging has not traditionally played a large role in the evaluation and staging of lung cancer. However, as protocols evolve and scan times decrease, MR is being investigated for lung cancer staging.
For the evaluation of lymph node metastases, STIR MR imaging has been evaluated [187]. Abnormal signal has been defined as a signal intensity greater than muscle (or it can also be quantified in relationship to a phantom) [187]. Reported sensitivities are 86-100%, specificity 71-97%, PPV 83%, NPV 87%, and an accuracy of 85-96% [187]. False positive examinations can occur in association with inflammation, active sarcoid, and motion [187].
Whole body MR imaging utilizing real time gradient echo imaging and a sliding table platform has become feasible [184,185]. Compare to PET/CT, whole body MR imaging is better at identifying brain and liver metastases, while PET/CT is better at identification og lymph node and soft tissue lesions [184].
