Highly Accelerated Pulmonary Nodule First Pass Perfusion for Improved Characterization of Indeterminate Pulmonary Nodules

Lung cancer is the leading cause of cancer mortality in the United States, and CT Lung Cancer Screening has been shown to reduce lung cancer mortality by greater than 20%. Unfortunately, CT is associated with many false positive results for lung nodules ranging from 6-15 mm in diameter. These nodules are found in ~50% or screening CTs and classified as “indeterminant” for malignancy. Patients then require imaging follow-up or biopsy which can delay diagnosis, increase patient anxiety, and increase healthcare costs. Due to recent engineering advances, Lung MRI is now clinically feasible, but not well-studied, particularly for indeterminant pulmonary nodules. Our group has recently developed a highly accelerated MRI tool to evaluate the three-dimensional blood perfusion of pulmonary nodules. Perfusion is important in cancer imaging because increased blood flow in tumors is often associated with higher grade disease. To establish the performance of our technique in combination with other MRI tissue characterization tools, we will perform lung MRI on patients with suspicious nodules undergoing biopsy as well as in patients with indeterminate nodules found on lung cancer screening CT. Our overarching goal is to determine how MRI can be incorporated in a comprehensive and cost-effective lung cancer screening program.