Subjective Visual Comparison and Surgical-Pathological Correlation of MRI and CT in Preoperative Evaluation of Lung Cancer

The clinical value of magnetic resonance imaging (MRI) and computed tomography (CT) for preoperative evaluation of lung cancer was studied. Subjective visual comparison of MRI with CT was done in 54 lung cancer cases, consisting of 37 surgical and 17 nonsurgical cases. Evaluation on the basis of surgical-pathological findings was performed on 37 surgical cases. Concerning the visibility of the margins of primary tumors within the peripheral lung field there was none in which MRI was superior to CT. As for the visibility of the tumors in relation to the mediastinum and abnormal mediastinal and hilar lymph node, MRI was either superior or equal to CT in the majority of cases. In the visualization of the tumors in relation to the chest wall CT was superior to MRI in 7 cases. The comparison of diagnostic accuracy on the basis of surgical-pathological findings showed that MRI was superior to CT in several cases for the T-factor. No difference of diagnostic accuracy was found between MRI and CT in the metastatic mediastinal and hilar lymph nodes. Since CT is currently more available and is easier to perform than MRI in most hospitals, CT is probably the first modality of choice in pre-operative evaluation of lung cancer. MRI is considered to be indicated in those cases in which the primary tumors are large and the relationship of the tumor to the mediastinum, heart, great vessels and chest wall must be clarified precisely or in which the diagnosis of metastasis of mediastinal and hilar lymph node is questionable on CT.