Evidence map›Paper›PMID 40221941›Full record

ArticleEuropean radiology2025

Longitudinal MRI in comparison to low-dose CT for follow-up of incidental pulmonary nodules in patients with COPD-a nationwide multicenter trial.

Lin Zhu, Qian Li, Oyunbileg von Stackelberg, Simon M F Triphan, Jürgen Biederer, Oliver Weinheimer, Monika Eichinger, Claus F Vogelmeier, Rudolf A Jörres, Hans-Ulrich Kauczor and 5 more

Abstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. MRI for Lung Cancer Management: Any Closer to Clinical Application?Journal of magnetic resonance imaging : JMRI · 2026
    Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Lin Zhu *Department of Radiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Qian Li *Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Oyunbileg von StackelbergDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Simon M F TriphanDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Jürgen BiedererDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Oliver WeinheimerDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Monika EichingerDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Claus F VogelmeierDepartment of Medicine, Pulmonary and Critical Care Medicine, Philipps-University of Marburg (UMR), Marburg, Germany.
Rudolf A JörresInstitute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilians University (LMU) Munich, Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany.
Hans-Ulrich KauczorDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Claus P HeußelDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Bertram J JobstDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Hong YuDepartment of Radiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Mark O WielpützDepartment of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany. mark.wielpuetz@med.uni-greifswald.de.ORCID http://orcid.org/0000-0001-6962-037X
COSYCONET study group

Funding

Aeronautical Science Foundation of China 82302188d Shanghai Health Research Foundation for Talents 2022YQ060German Federal Ministry of Education and Research BMBF to the German Center for Lung research 82DZL004A1German Federal Ministry of Education and Research BMBF to the German Center for Lung research 82DZL009B1National Natural Science Foundation of China 82071873Shanghai Pujiang Program 22PJD069
6 · The paper itself

Abstract

purposeThis multicenter trial was conducted to evaluate MRI for the longitudinal management of incidental pulmonary nodules in heavy smokers. MATERIALS AND

methods239 participants (63.9 ± 8.4 years, 43-82 years) at risk of or with COPD GOLDI-IV from 16 centers prospectively underwent two rounds of same-day low-dose computed tomography (LDCT1&2) and MRI1&2 at an interval of three years in the nationwide COSYCONET trial. All exams were independently assessed for incidental pulmonary nodules in a standardized fashion by two blinded readers, incl. axis measurements and Lung-RADS categorization, with consensual LDCT results serving as the standard of reference. A change in diameter ≥ 2 mm was rated as progress. 11 patients underwent surgery for suspicious nodules after the first round.

resultsTwo hundred twenty-four of two hundred forty nodules (93.3%) persisted from LDCT1 to LDCT2, with a sensitivity of MRI2 of 82.8% and 81.5% for readers 1 and 2, respectively. Agreement in Lung-RADS categories between LDCT2 and MRI2 was substantial in per-nodule (κ = 0.62-0.70) and excellent in a per-patient (κ = 0.86-0.88) approach for both readers, respectively. Concordance between LDCT2 and MRI2 for growth was excellent to almost perfect (κ = 0.88-1.0). The accuracy of LDCT1 and MRI1 for lung cancer was 87.5%. Lung-RADS ≥ 3 category on MRI1 had higher accuracy for predicting progress (23.1% and 21.4%, respectively) than LDCT1 (15.8%).

conclusionCompared to LDCT, MRI shows similar capabilities for the longitudinal evaluation of incidental nodules in heavy smokers. Decision-making for nodule management guided by Lung-RADS seems feasible based on longitudinal MRI. KEY POINTS: Question Can MRI serve as an alternative to low-dose CT (LDCT) for the longitudinal management of pulmonary nodules in heavy smokers, addressing concerns over radiation exposure? Findings MRI demonstrated substantial agreement with LDCT in detecting nodule growth, accurately categorizing Lung-RADS, and comparable accuracy in identifying malignancy over a three-year follow-up. Clinical relevance Longitudinal MRI demonstrates high consistency with LDCT in assessing the growth of incidental pulmonary nodules and categorizing per-patient Lung-RADS, offering a reliable, radiation-free alternative for monitoring and early malignancy detection in high-risk populations.

Indexed as

Lung NeoplasmsMagnetic Resonance ImagingMultiple Pulmonary NodulesPulmonary Disease, Chronic ObstructiveSolitary Pulmonary NoduleTomography, X-Ray ComputedAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansIncidental FindingsLongitudinal StudiesMaleMiddle AgedChronic obstructive pulmonary diseaseLongitudinal managementLow-dose computed tomographyMagnetic resonance imagingPulmonary nodules

Identifiers

PMID40221941
PMCPMC12417304

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.