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Patients scanned within 24\u2009h using PCD-CT, for comparison, were enrolled. Lung-RADS scores were evaluated per patient, and all nodules were assessed for size and composition. The diagnostic performance of MRI was compared with PCD-CT, including interobserver and intermodality agreement, using Lin\u2019s Concordance Correlation Coefficient (CCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>97 patients were enrolled (65 men, 67%; mean age 58\u2009\u00b1\u200912 years old) and 33 (34%) were active smokers. MRI and CT showed complete agreement in the Lung-RADS 4A and 4B categories. MRI demonstrated an overall sensitivity of 83.1% (95% CI: 73.2\u201389.9) for solid nodules, increasing to 98.1% (95% CI: 90.2\u201399.7) for nodules \u2265\u20094\u2009mm. Lin\u2019s CCC for nodule size was 0.985, indicating excellent agreement, with MRI showing a slight underestimation of 1.02\u2009mm (95% CI: [\u22121.16, 3.20]) in Bland\u2013Altman analysis. MRI failed to detect calcified nodules &lt;\u20094\u2009mm, which accounted for 51.2% of undetected nodules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A single breath-hold AI-CS accelerated 3D-T1-FFE MRI scan can be a valuable tool for solid lung nodule screening, showing very good agreement with CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>May lung MRI using an optimized AI-CS accelerated 3D-T1-FFE sequence acquired in a single breath hold be a radiation-free alternative to CT in lung cancer screening?<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Lung MRI using AI-CS 3D-T1-FFE sequence achieved an overall accuracy of 87.3% for detecting solid nodules overall, increasing to 97.7% for nodules \u2265\u20094\u2009mm.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Lung MRI using an optimized AI-CS 3D-T1-FFE is a promising alternative to chest CT in lung nodules screening, offering high diagnostic accuracy, especially for clinically relevant nodules, excellent Lung-RADS classification agreement, and short acquisition time (17.2\u2009s [IQR, 17.2\u201317.3])<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12738-7","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:39:45Z","timestamp":1783687185000},"page":"8322-8331","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic performance of a single breath-hold lung MRI scan with AI-powered compressed sensing for nodule detection in comparison to photon counting detector-CT"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1564-2060","authenticated-orcid":false,"given":"Anna","family":"Palmisano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Piccinni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Serra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Bruno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Ferrazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Vignale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Tacchetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"12738_CR1","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1002\/ijc.33588","volume":"149","author":"J Ferlay","year":"2021","unstructured":"Ferlay J, Colombet M, Soerjomataram I et al (2021) Cancer statistics for the year 2020: an overview. 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The remaining authors of this manuscript declare no relationship with any companies, whose products or services may be related to the subject matter of the article.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"One of the authors has significant statistical expertise.","order":3,"name":"Ethics","label":"Statistics and biometry","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Written informed consent was obtained from all subjects (patients) in this study.","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Institutional Review Board approval was obtained. The study was approved by the local Ethics Committee (AIMOMICS-BANK CET 233-2024).","order":5,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Data were not previously published or presented.","order":6,"name":"Ethics","label":"Study subjects or cohorts overlap","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"order":7,"name":"Ethics","label":"Methodology","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}