Volumetric dynamic oxygen-enhanced MRI (OE-MRI): comparison with CT Brody score and lung function in cystic fibrosis patients
Abstract
Objectives
To demonstrate, in patients with cystic fibrosis (CF), the correlation between three-dimensional dynamic oxygen-enhanced magnetic resonance imaging (OE-MRI) measurements and computed tomography Brody score (CF-CT) and lung function testing (LFT).
Methods
Twenty-one patients (median age, 25 years; female, n = 8) with a range of CF lung disease and five healthy volunteers (median age, 31 years; female, n = 2) underwent OE-MRI performed on a 1.5-T MRI scanner. Coronal volumes were acquired while patients alternately breathed room air and 100% oxygen. Pre-oxygen T1 was measured. Dynamic series of T1-weighted volumes were then obtained while breathing oxygen. T1-parameter maps were generated and the following OE-MRI parameters were measured: oxygen uptake (ΔPO2max), wash-in time and wash-out time. High-resolution CT and LFT were performed. The relationship between CF-CT, LFT and OE-MRI parameters were evaluated using Pearson correlation for the whole lung and regionally.
Results
Mean CF-CT was 24.1±17.1. Mean ΔPO2max and mean wash-in as well as skewness of wash-out showed significant correlation with CF-CT (ΔPO2max: r = -0.741, p < 0.001; mean wash-in: r = 0.501, p = 0.017; skewness of wash-out: r = 0.597, p = 0.001). There was significant correlation for the whole lung and regionally between LFT parameters and OE-MR (ΔPO2max: r = 0.718, p < 0.001; wash-in: r = -0.576, p = 0.003; wash-out skewness: r = -0.552, p = 0.004).
Conclusions
Functional lung imaging using OE-MRI has the capability to assess the severity of CF lung disease and shows a significant correlation with LFT and CF-CT.
Key points
• Oxygen-enhanced MRI might play a future role in evaluation and follow-up of cystic fibrosis.
• Heterogeneity of parameter maps reflects localised functional impairment in cystic fibrosis.
• Avoidance of cumulative radiation burden in CF is feasible using OE-MRI.
Keywords
Lung disease Cystic fibrosis Lung Magnetic resonance imaging MRIAbbreviations
- ΔPO2max
Delta partial pressure of oxygen in parenchyma
- AT-CT
Subscore for air trapping
- BR-CT
Subscore for bronchial changes
- CF
Cystic fibrosis
- CF-CT
Computed tomography Brody score
- ECFS
CT Standards of Care of the European CF Society
- FEV1
Forced expiratory volume in 1 s
- FVC
Forced vital capacity
- HRCT
High-resolution computed tomography
- LFT
Lung function test
- MMEF
Maximum mid-expiratory flow
Notes
Acknowledgements
Support and the provision of research features from Philips Clinical Science is gratefully acknowledged.
Funding
This study has received funding by the Swiss Lung association (Lungenliga Schweiz).
Compliance with ethical standards
Guarantor
The scientific guarantor of this publication is Prof. Thomas Frauenfelder.
Conflict of interest
The authors Dr. Martini, Ms. Gygax, Dr. Benden and Dr. Frauenfelder declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
The authors of this manuscript declare relationships with the following companies: Dr. Morgan reports personal fees from Bioxydyn Ltd, during the conduct of the study; personal fees from GSK, outside the submitted work.
Dr. Parker reports personal fees from Bioxydyn Ltd, during the conduct of the study. In addition, Dr. Parker has a patent PCT/GB2008/001390 issued, and a patent PCT/GB2010/001989 issued.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Informed consent
Written informed consent was obtained from all subjects (patients) in this study.
Ethical approval
Institutional Review Board approval was obtained.
Methodology
• prospective
• diagnostic or prognostic study
• performed at one institution
Supplementary material
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