Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 11/2016

01-11-2016 | Chest

Lung morphology assessment of cystic fibrosis using MRI with ultra-short echo time at submillimeter spatial resolution

Authors: Gaël Dournes, Fanny Menut, Julie Macey, Michaël Fayon, Jean-François Chateil, Marjorie Salel, Olivier Corneloup, Michel Montaudon, Patrick Berger, François Laurent

Published in: European Radiology | Issue 11/2016

Login to get access

Abstract

Objectives

We hypothesized that non-contrast-enhanced PETRA (pointwise encoding time reduction with radial acquisition) MR (magnetic resonance) sequencing could be an alternative to unenhanced computed tomography (CT) in assessing cystic fibrosis (CF) lung structural alterations, as well as compared agreements and concordances with those of conventional T1-weighted and T2-weighted sequences.

Material and methods

Thirty consecutive CF patients completed both CT and MRI the same day. No contrast injection was used. Agreement in identifying structural alterations was evaluated at the segmental level using a kappa test. Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to assess concordances and reproducibility in Helbich-Bhalla disease severity scoring.

Results

Agreement between PETRA and CT was higher than that of T1- or T2-weighted sequences, notably in assessing the segmental presence of bronchiectasis (Kappa = 0.83; 0.51; 0.49, respectively). The concordance in Helbich-Bhalla scores was very good using PETRA (ICC = 0.97), independently from its magnitude (mean difference (MD) = -0.3 [-2.8; 2.2]), whereas scoring was underestimated using both conventional T1 and T2 sequences (MD = -3.6 [-7.4; 0.1]) and MD = -4.6 [-8.2; -1.0], respectively). Intra- and interobserver reproducibility were very good for all imaging modalities (ICC = 0.86-0.98).

Conclusion

PETRA showed higher agreement in describing CF lung morphological changes than that of conventional sequences, whereas the Helbich-Bhalla scoring matched closely with that of CT.

Key Points

• Spatial resolution of lung MRI is limited using non-ultra-short TE MRI technique
• Ultra-short echo time (UTE) technique enables submillimeter 3D-MRI of airways
• 3D-UTE MRI shows very good concordance with CT in assessing cystic fibrosis
• Radiation-free 3D-UTE MRI enables the Helbich-Bhalla scoring without a need for contrast injection
Appendix
Available only for authorised users
Literature
1.
2.
Kuehn BM (2014) Progress in treating cystic fibrosis means that many patients may now reach midlife and beyond. JAMA 312:1182–1183CrossRefPubMed
3.
Loeve M, Krestin GP, Rosenfeld M, de Bruijne M, Stick SM, Tiddens HA (2013) Chest computed tomography: a validated surrogate endpoint of cystic fibrosis lung disease? Eur Respir J 42:844–857CrossRefPubMed
4.
Bhalla M, Turcios N, Aponte V et al (1991) Cystic fibrosis: scoring system with thin-section CT. Radiology 179:783–788CrossRefPubMed
5.
de Jong PA, Lindblad A, Rubin L et al (2006) Progression of lung disease on computed tomography and pulmonary function tests in children and adults with cystic fibrosis. Thorax 61:80–85CrossRefPubMed
6.
O'Connor OJ, Vandeleur M, McGarrigle AM et al (2010) Development of low-dose protocols for thin-section CT assessment of cystic fibrosis in pediatric patients. Radiology 257:820–829CrossRefPubMed
7.
8.
Wielputz MO, Mall MA (2015) Imaging modalities in cystic fibrosis: emerging role of MRI. Curr Opin Pulm Med 21:609–616CrossRefPubMed
9.
Altes TA, Eichinger M, Puderbach M (2007) Magnetic resonance imaging of the lung in cystic fibrosis. Proc Am Thorac Soc 4:321–327CrossRefPubMed
10.
11.
Kanda T, Ishii K, Kawaguchi H, Kitajima K, Takenaka D (2014) High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: Relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology 270:834–841CrossRefPubMed
12.
Tepper LA, Ciet P, Caudri D, Quittner AL, Utens EM, Tiddens HA (2015) Validating chest MRI to detect and monitor cystic fibrosis lung disease in a pediatric cohort. Pediatr Pulmonol. doi:10.​1002/​ppul.​23328
13.
Eichinger M, Optazaite DE, Kopp-Schneider A et al (2012) Morphologic and functional scoring of cystic fibrosis lung disease using MRI. Eur J Radiol 81:1321–1329CrossRefPubMed
14.
Puderbach M, Eichinger M, Gahr J et al (2007) Proton MRI appearance of cystic fibrosis: comparison to CT. Eur Radiol 17:716–724CrossRefPubMed
15.
Renz DM, Scholz O, Bottcher J et al (2015) 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. doi:10.​1097/​RLI.​0000000000000178​ PubMed
16.
17.
Sileo C, Corvol H, Boelle PY, Blondiaux E, Clement A, Ducou Le Pointe H (2014) HRCT and MRI of the lung in children with cystic fibrosis: comparison of different scoring systems. J Cyst Fibros 13:198–204CrossRefPubMed
18.
Johnson KM, Fain SB, Schiebler ML, Nagle S (2013) Optimized 3D ultrashort echo time pulmonary MRI. Magn Reson Med 70:1241–1250CrossRefPubMed
19.
20.
Ohno Y, Koyama H, Yoshikawa T et al (2015) Pulmonary high-resolution ultrashort TE MR imaging: comparison with thin-section standard- and low-dose computed tomography for the assessment of pulmonary parenchyma diseases. J Magn Reson Imaging. doi:10.​1002/​jmri.​25008
21.
Helbich TH, Heinz-Peer G, Eichler I et al (1999) Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology 213:537–544CrossRefPubMed
22.
de Jong PA, Ottink MD, Robben SG et al (2004) Pulmonary disease assessment in cystic fibrosis: comparison of CT scoring systems and value of bronchial and arterial dimension measurements. Radiology 231:434–439CrossRefPubMed
23.
Kerem E, Conway S, Elborn S, Heijerman H, Consensus C (2005) Standards of care for patients with cystic fibrosis: a European consensus. J Cyst Fibros 4:7–26CrossRefPubMed
24.
The Cystic Fibrosis Foundation Center Committee and Guidelines Subcommittee (1990). Cystic Fibrosis Foundation guidelines for patient services, evaluation, and monitoring in cystic fibrosis centers.. Am J Dis Child 144:1311–1312
25.
Wielputz MO, Heussel CP, Herth FJ, Kauczor HU (2014) Radiological diagnosis in lung disease: factoring treatment options into the choice of diagnostic modality. Dtsch Arztebl Int 111:181–187PubMedPubMedCentral
26.
27.
Loeve M, Lequin MH, de Bruijne M et al (2009) Cystic fibrosis: are volumetric ultra-low-dose expiratory CT scans sufficient for monitoring related lung disease? Radiology 253:223–229CrossRefPubMed
28.
Lee ES, Lee JM, Yu MH et al (2014) High spatial resolution, respiratory-gated, t1-weighted magnetic resonance imaging of the liver and the biliary tract during the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance imaging. J Comput Assist Tomogr 38:360–366CrossRefPubMed
29.
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722CrossRefPubMed
30.
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
31.
32.
33.
Grodzki DM, Jakob PM, Heismann B (2012) Ultrashort echo time imaging using pointwise encoding time reduction with radial acquisition (PETRA). Magn Reson Med 67:510–518CrossRefPubMed
34.
Bankier AA, De Maertelaer V, Keyzer C, Gevenois PA (1999) Pulmonary emphysema: subjective visual grading versus objective quantification with macroscopic morphometry and thin-section CT densitometry. Radiology 211:851–858CrossRefPubMed
35.
Ernst CW, Basten IA, Ilsen B et al (2014) Pulmonary disease in cystic fibrosis: assessment with chest CT at chest radiography dose levels. Radiology 273:597–605CrossRefPubMed
36.
Rosenow T, Oudraad MC, Murray CP et al (2015) PRAGMA-CF. A quantitative structural lung disease computed tomography outcome in young children with cystic fibrosis. Am J Respir Crit Care Med 191:1158–1165CrossRefPubMed
37.
Fink C, Puderbach M, Biederer J et al (2007) Lung MRI at 1.5 and 3 Tesla: observer preference study and lesion contrast using five different pulse sequences. Invest Radiol 42:377–383CrossRefPubMed
38.
Yan C, Tan X, Wei Q et al (2015) Lung MRI of invasive fungal infection at 3 Tesla: evaluation of five different pulse sequences and comparison with multidetector computed tomography (MDCT). Eur Radiol 25:550–557CrossRefPubMed
39.
Wielputz MO, Puderbach M, Kopp-Schneider A et al (2014) Magnetic resonance imaging detects changes in structure and perfusion, and response to therapy in early cystic fibrosis lung disease. Am J Respir Crit Care Med 189:956–965CrossRefPubMed
40.
Maisonneuve P, Marshall BC, Knapp EA, Lowenfels AB (2013) Cancer risk in cystic fibrosis: a 20-year nationwide study from the United States. J Natl Cancer Inst 105:122–129CrossRefPubMed
41.
Buzan MT, Eichinger M, Kreuter M et al (2015) T2 mapping of CT remodelling patterns in interstitial lung disease. Eur Radiol 25:3167–3174CrossRefPubMed
42.
Bryant M, Ley S, Eberhardt R et al (2015) Assessment of the relationship between morphological emphysema phenotype and corresponding pulmonary perfusion pattern on a segmental level. Eur Radiol 25:72–80CrossRefPubMed
Metadata
Title
Lung morphology assessment of cystic fibrosis using MRI with ultra-short echo time at submillimeter spatial resolution
Authors
Gaël Dournes
Fanny Menut
Julie Macey
Michaël Fayon
Jean-François Chateil
Marjorie Salel
Olivier Corneloup
Michel Montaudon
Patrick Berger
François Laurent
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4218-5

Other articles of this Issue 11/2016

European Radiology 11/2016 Go to the issue

Nuclear Medicine

18F-FDG PET/CT assessment of histopathologically confirmed mediastinal lymph nodes in non-small cell lung cancer using a penalised likelihood reconstruction

Magnetic Resonance

Association between magnetic resonance imaging patterns and baseline disease features in multiple myeloma: analyzing surrogates of tumour mass and biology

Breast

False positives in breast cancer screening with one-view breast tomosynthesis: An analysis of findings leading to recall, work-up and biopsy rates in the Malmö Breast Tomosynthesis Screening Trial

Cardiac

Cardiac magnetic resonance findings predicting mortality in patients with pulmonary arterial hypertension: a systematic review and meta-analysis

Hepatobiliary-Pancreas

Cost evaluation of gadoxetic acid-enhanced magnetic resonance imaging in the diagnosis of colorectal-cancer metastasis in the liver: Results from the VALUE Trial

Cardiac

Differentiation of myocardial ischemia and infarction assessed by dynamic computed tomography perfusion imaging and comparison with cardiac magnetic resonance and single-photon emission computed tomography