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MDCT and MRI in Bronchiectasis in Older Children and Young Adults – A Non-Inferiority Trial

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To compare and evaluate the usefulness of magnetic resonance imaging (MRI) with computed tomography (CT) in bronchiectasis; to compare MRI and CT scores with pulmonary function tests (PFT) and to evaluate the role of Diffusion-weighted imaging (DWI) in bronchiectasis.

Methods

In this prospective study, 25 patients between 7–21 y of age with a clinical/radiological diagnosis of bronchiectasis underwent MDCT and MRI chest. MRI and CT scoring was performed using modified Bhalla-Helbich’s score by two independent radiologists for all parameters. A final consensus score was recorded. The overall image quality of different MRI sequences to identify pathologies was also assessed. Appropriate statistical tests were used for inter-observer agreements, and correlation amongst CT and MRI; as well as CT, MRI and PFT.

Results

Strong agreement (ICC 0.80–0.95) between CT and MRI was seen for extent and severity of bronchiectasis, number of bullae, sacculation/abscess, emphysema, collapse/ consolidation, mucus plugging, and mosaic perfusion. Overall CT and MRI scores had perfect concordance (ICC 0.978). Statistically significant (p-value <0.01) intra-observer and inter-observer agreement for all CT and MRI score parameters were seen. A strong negative correlation was seen between total CT and MRI severity scores and forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow (FEF) 25–75%. DWI MR, with an apparent diffusion coefficient (ADC) cut-off of 1.62 × 10–3 mm3/s had a sensitivity of 70% and specificity of 75% in detecting true mucus plugs.

Conclusions

MRI with DWI can be considered as a radiation-free alternative in the diagnostic algorithm for assessment of lung changes in bronchiectasis, especially in follow-up.

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References

  1. Causes of Bronchiectasis in Children - UpToDate [Internet]. 2019. Available at: https://www.uptodate.com/contents/causes-of-bronchiectasis-in-children?search=bronchiectasis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H4. Accessed on 28 Mar 2019.

  2. Singh A, Bhalla AS, Jana M. Bronchiectasis revisited: Imaging-based pattern approach to diagnosis. Curr Probl Diagn Radiol. 2019;48:53–60.

    Article  PubMed  Google Scholar 

  3. Endpoints for Clinical Trials in Young Children with Cystic Fibrosis. 2019. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647606/. Accessed on 30 Apr 2019.

  4. Computed Tomography Reflects Lower Airway Inflammation and Tracks Changes in Early Cystic Fibrosis. 2019. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17303797. Accessed on 30 Apr 2019.

  5. de Jong PA, Mayo JR, Golmohammadi K, et al. Estimation of cancer mortality associated with repetitive computed tomography scanning. Am J Respir Crit Care Med. 2006;173:199–203.

    Article  PubMed  Google Scholar 

  6. Loeve M, Lequin MH, de Bruijne M, et al. Cystic fibrosis: Are volumetric ultra-low-dose expiratory CT scans sufficient for monitoring related lung disease? Radiology. 2009;253:223–9.

    Article  PubMed  Google Scholar 

  7. Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: A retrospective cohort study. Lancet. 2012;380:499–505.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Eichinger M, Optazaite DE, Kopp-Schneider A, et al. Morphologic and functional scoring of cystic fibrosis lung disease using MRI. Eur J Radiol. 2012;81:1321–9.

    Article  PubMed  Google Scholar 

  9. Puderbach M, Eichinger M, Haeselbarth J, et al. Assessment of morphological MRI for pulmonary changes in cystic fibrosis (CF) patients: Comparison to thin-section CT and chest x-ray. Invest Radiol. 2007;42:715–25.

    Article  PubMed  Google Scholar 

  10. Helbich TH, Heinz-Peer G, Eichler I, et al. Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology. 1999;213:537–44.

    Article  CAS  PubMed  Google Scholar 

  11. Bhalla M, Turcios N, Aponte V, et al. Cystic fibrosis: Scoring system with thin-section CT. Radiology. 1991;179:783–8.

    Article  CAS  PubMed  Google Scholar 

  12. Sileo C, Corvol H, Boelle P-Y, Blondiaux E, Clement A, Le Pointe HD. HRCT and MRI of the lung in children with cystic fibrosis: Comparison of different scoring systems. J Cyst Fibros. 2014;13:198–204.

    Article  PubMed  Google Scholar 

  13. Renz DM, Scholz O, Böttcher J, et al. Comparison between magnetic resonance imaging and computed tomography of the lung in patients with cystic fibrosis with regard to clinical, laboratory, and pulmonary functional parameters. Invest Radiol. 2015;50:733–42.

    Article  PubMed  Google Scholar 

  14. Montella S, Santamaria F, Salvatore M, et al. Assessment of chest high-field magnetic resonance imaging in children and young adults with noncystic fibrosis chronic lung disease: Comparison to high-resolution computed tomography and correlation with pulmonary function. Invest Radiol. 2009;44:532–8.

    Article  PubMed  Google Scholar 

  15. Ma W, Sheikh K, Svenningsen S, et al. Ultra-short echo-time pulmonary MRI: Evaluation and reproducibility in COPD subjects with and without bronchiectasis. J Magn Reson Imaging. 2015;41:1465–74.

    Article  PubMed  Google Scholar 

  16. Dournes G, Grodzki D, Macey J, et al. Quiet submillimeter MR imaging of the lung is feasible with a PETRA sequence at 1.5 T. Radiology. 2015;276:258–65.

    Article  PubMed  Google Scholar 

  17. Ciet P, Serra G, Andrinopoulou ER, et al. Diffusion weighted imaging in cystic fibrosis disease: Beyond morphological imaging. Eur Radiol. 2016;26:3830–9.

    Article  PubMed  Google Scholar 

  18. Bauman G, Puderbach M, Heimann T, et al. Validation of Fourier decomposition MRI with dynamic contrast-enhanced MRI using visual and automated scoring of pulmonary perfusion in young cystic fibrosis patients. Eur J Radiol. 2013;82:2371–7.

    Article  PubMed  Google Scholar 

  19. Stahl M, Steinke E, Graeber SY, et al. Magnetic resonance imaging detects progression of lung disease and impact of newborn screening in preschool children with cystic fibrosis. Am J Respir Crit Care Med. 2021;204:943–53.

    Article  PubMed  Google Scholar 

  20. Murphy KP, Maher MM, O’Connor OJ. Imaging of cystic fibrosis and pediatric bronchiectasis. Am J Roentgenol. 2016;206:448–54.

    Article  Google Scholar 

  21. Sodhi KS, Sharma M, Lee EY, et al. Diagnostic utility of 3T lung MRI in children with interstitial lung disease: A prospective pilot study. Acad Radiol. 2018;25:380–6.

    Article  PubMed  Google Scholar 

  22. Sodhi KS, Sharma M, Saxena AK, Mathew JL, Singh M, Khandelwal N. MRI in thoracic tuberculosis of children. Indian J Pediatr. 2017;84:670–6.

    Article  PubMed  Google Scholar 

  23. Kapur S, Jana M, Gupta L, Bhalla AS, Naranje P, Gupta AK. Chest MRI using multivane-XD, a novel T2-weighted free breathing MR sequence. Curr Probl Diagn Radiol. 2021;50:41–7.

    Article  PubMed  Google Scholar 

  24. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15:155–63.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.

    Article  CAS  PubMed  Google Scholar 

  26. Ciet P, Serra G, Bertolo S, et al. Assessment of CF lung disease using motion corrected PROPELLER MRI: A comparison with CT. Eur Radiol. 2016;26:780–7.

    Article  PubMed  Google Scholar 

  27. Sodhi KS, Khandelwal N, Saxena AK, et al. Rapid lung MRI in children with pulmonary infections: Time to change our diagnostic algorithms: Rapid lung MRI in children. J Magn Reson Imaging. 2016;43:1196–206.

    Article  PubMed  Google Scholar 

  28. Teufel M, Ketelsen D, Fleischer S, et al. Comparison between high-resolution CT and MRI using a very short echo time in patients with cystic fibrosis with extra focus on mosaic attenuation. Respiration. 2013;86:302–11.

    Article  PubMed  Google Scholar 

  29. Milito C, Pulvirenti F, Serra G, et al. Lung magnetic resonance imaging with diffusion weighted imaging provides regional structural as well as functional information without radiation exposure in primary antibody deficiencies. J Clin Immunol. 2015;35:491–500.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Lokesh, Manisha Jana, Priyanka Naranje, Ashu Seith Bhalla & Arun Kumar Gupta

  2. Department of Pediatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Sushil K. Kabra

  3. Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Vijay Hadda

Authors
  1. Lokesh
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  2. Manisha Jana
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  3. Priyanka Naranje
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  4. Ashu Seith Bhalla
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  5. Sushil K. Kabra
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  6. Vijay Hadda
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  7. Arun Kumar Gupta
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Contributions

L: Literature search, manuscript preparation and editing and data curation; MJ: Conceptualization, manuscript editing and contribution to figures; PN, ASB: Manuscript editing and contribution to figures; SKK, VH, AKG: Manuscript editing and review. MJ will act as guarantor for this manuscript.

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Correspondence to Manisha Jana.

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Lokesh, Jana, M., Naranje, P. et al. MDCT and MRI in Bronchiectasis in Older Children and Young Adults – A Non-Inferiority Trial. Indian J Pediatr (2023). https://doi.org/10.1007/s12098-023-04921-1

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