Identification of invasive adenocarcinoma in pulmonary ground-glass nodules using zero echo time magnetic resonance imaging (ZTE-MRI)

Intra-modality and inter-reader agreements of ground-glass opacity nodule (GGN) size were good between modalities (ZTE-MRI, T2WI-FS, CT). ZTE-MRI was susceptible to motion artifacts caused by breathing and vascular pulsation and had difficulty in displaying GGNs in specific lung locations, but was sensitive to GGNs with CT values of >-455 HU, highly possibly lung invasive adenocarcinomas, giving a hint to treatment strategies. In contrast, T2WI-FS can detect a smaller size of 6 mm for GGNs than ZTE-MRI. Overall, ZTE might play a unique role in differentiating invasive adenocarcinomas from precursor glandular lesions and minimally invasive adenocarcinoma (MIA) in eligible GGNs.