Respiratory dynamic magnetic resonance imaging for determining aortic invasion of thoracic neoplasms

Objective An accurate radiological method for evaluating the presence or extent of aortic invasion by thoracic cancer is essential in the preoperative setting. The aim of this study was to assess whether respiratory dynamic (RD) magnetic resonance imaging (MRI) more accurately detects aortic invasion of mediastinal tumors and lung cancer compared with conventional MRI or computed tomography (CT). Methods Twenty-six patients (19 male, 7 female; mean age, 63.08 ± 12.05 years) with inconclusive evidence of aortic invasion on chest CT underwent MRI (conventional and RD MRI using a balanced fast field echo sequence with a 1.5 T unit). The presence of aortic invasion was determined by fixation of the aorta and lack of synchronous motion during respiration on RD MRI. The results of CT and MRI were compared with the pathology results. The sensitivity, specificity, and accuracy of CT, conventional MRI, and conventional MRI with RD MRI were compared. Results Of 26 patients, 5 patients had invasion of the aorta. The sensitivity for determining aortic invasion was 100% using CT alone, conventional MRI alone, and conventional MRI with RD MRI. The specificity and accuracy for conventional MRI with RD MRI were significantly higher (71.4% and 76.9%, respectively) than for CT (28.5% and 42.3%, P <.05) or conventional MRI alone (33.3% and 46.1%, P <.05). Conclusions RD MRI may improve the diagnostic accuracy of MRI by predicting aortic invasion use in preoperative staging.