Mediastinal and Pleural MR Imaging in Daily Practice

Our plain-English summary of Mediastinal and Pleural MR Imaging in Daily Practice, by A.M. Priola, A. Veltri, S.M. Priola (Radiographics, 2018).

The study

• Authors: A.M. Priola, A. Veltri, S.M. Priola
• Journal: Radiographics
• Published: 2018;38(3):981-982
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This item was a letter to the editor with a reply, not a research study, and it did not mention asbestos. Three radiologists in Torino, Italy, commented on a RadioGraphics review by Raptis and colleagues of MR imaging of the mediastinum (central chest) and pleura. The writers said the review lacked basic advice on measuring the apparent diffusion coefficient (ADC). They wrote that a b value of 0 should be excluded from ADC calculations. They cited their own anterior mediastinum study, in which including it overestimated ADC by 22.4% for malignancies versus 5.3% for benign conditions. They advised keeping echo time short, typically 50 to 65 msec. They did not fully agree with the review's framing of MR imaging as a check on whether a lesion found at CT is certainly or near certainly benign, citing its potential first-line role in selected conditions. The review authors replied that they do not routinely make quantitative ADC measurements for most thoracic lesions, using diffusion imaging mainly qualitatively. They added that quantitative analysis is not essential at present for most thoracic MR examinations.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor commenting on a published review, followed by a reply from the review's authors
• Who was studied: No patients or subjects were studied; the letter discusses a review article by Raptis et al on mediastinal and pleural MR imaging
• Main results:
  • The letter writers stated that the b value of 0 sec/mm2 must be excluded from ADC maps and ADC calculations to avoid overestimating ADC because of tissue perfusion
  • The letter writers cited their own earlier (2016) study of the anterior mediastinum, not new data in this letter. It reported that ADC overestimation was higher for malignancies than for benign conditions (22.4% vs 5.3%)
  • The letter writers did not fully agree with the review's statement that MR imaging is used to determine whether a lesion detected at CT is certainly or near certainly benign. They cited a potential first-line role for MR imaging in selected conditions, such as assessing the thymus in myasthenia gravis and monitoring mediastinal lymphoma
  • In reply, the review authors stated that they do not routinely perform quantitative ADC measurements for most thoracic lesions
  • The review authors also stated that quantitative ADC analysis is not essential or warranted at present for interpreting most thoracic MR imaging examinations
• The authors' conclusion: The letter writers concluded that, for diffusion-weighted MR imaging of the thorax, echo time should be kept as short as possible, typically 50 to 65 msec, to avoid underestimating ADC

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

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