Roya S. Saleh MD, Presenter: Nothing to Disclose

Robert Cameron MD, Abstract Co-Author: Nothing to Disclose

Abbas Moghaddam, Abstract Co-Author: Nothing to Disclose

Raja Mahidhara MD, Abstract Co-Author: Nothing to Disclose

Jonathan G. Goldin MBChB, PhD, Abstract Co-Author: Director, MedQIA Imaging Core

J. Paul Finn MD, Abstract Co-Author: Research Consultant, Siemens AG Speakers Bureau, Bayer AG

Malignant Pleural MESOTHELIOMA (MPM) invades the parietal pleura and can manifest as restrictive lung disease. MRI can be used safely to both visualize the anatomy and predict the extent of restrictive disease by quantifying regional chest dynamics. Thus, we aimed to assess the feasibility of MRI in MPM patients (pts).

11 MPM pts (9M; 65± 6) and 11 healthy controls (9M; 35±10) were examined with realtime dynamic MRI (Steady State Free Precession) with temporal resolution of 8 f/s. Using a 1.5 Tesla scanner (Avanto, Siemens), 1 coronal and 2 sagittal planes were interrogated twice; once during quiet breathing (QB) and another during maximum respiratory effort (MEf). 128 images were acquired during a continuous acquisition at 8 f/s. Resulting images were contoured digitally to estimate the End Inspiratory Lung Volume (EILV) and End Expiratory Lung Volume (EELV) for each slice during both QB and breathing with MEf. The above measurements were used to further calculate the segmented Inspiratory Reserve Volume Fraction (IRVF %=(ILVMEf -EILVQB)/ EILVQB) and segmented Expansion Fraction (Expandability of each hemithorax EEQB or MEf=(EILV-EELV)/EELV).  ANOVA test was used to test the significance of difference in the above indices between disease and normal hemithorax of pts and control. A t-test was used to test the significance of difference between each two groups.  

4 pts had left and 7 had right MPM. The diseased hemithorax showed significantly (p< 0.05) lower chest function indices than both the contralateral side and controls. Sag view IRVF, EFQB and EFMEf were12.9± 10 ;13.3± 10.4 and 32.9±15 vs 56± 18.9 ; 28± 8.9 and 84.9± 21.4 for the contralateral hemithorax and 61.6±26; 32.5± 25and 107.5±34.7 for control.

In MPM pts, MRI can be used to measure dynamic regional thoracic volume changes, which may reflect the degree of regional functional impairment.

In MPM pts, dynamic functional imaging with MRI may play a role in selecting candidates for specific therapies such as surgery or chemotherapy and in monitoring the response to treatment.  

Saleh, R, Cameron, R, Moghaddam, A, Mahidhara, R, Goldin, J, Finn, J, Chest Dynamics in Malignant Pleural Mesothelioma (MPM) Patients Using Real Time Respiratory Cine MRI.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6011083.html