Top

European Radiology

Published in:

01-10-2018 | Chest

Volumetric dynamic oxygen-enhanced MRI (OE-MRI): comparison with CT Brody score and lung function in cystic fibrosis patients

Authors: K. Martini, C. M. Gygax, C. Benden, A. R. Morgan, G. J. M. Parker, T. Frauenfelder

Published in: European Radiology | Issue 10/2018

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 (ΔPO_2max), 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 ΔPO_2max and mean wash-in as well as skewness of wash-out showed significant correlation with CF-CT (ΔPO_2max: 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 (ΔPO_2max: 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.

Available only for authorised users

Smyth AR, Bell SC, Bojcin S, Bryon M, Duff A, Flume P et al (2014) European Cystic Fibrosis Society Standards of Care: Best Practice guidelines. J Cyst Fibros 13:S23–S42CrossRef

Marshall H, Horsley A, Taylor CJ, Smith L, Hughes D, Horn FC et al (2017) Detection of early subclinical lung disease in children with cystic fibrosis by lung ventilation imaging with hyperpolarised gas MRI. Thorax 72:760–762CrossRef

van Beek EJ, Wild JM, Kauczor HU, Schreiber W, Mugler JP 3rd, de Lange EE (2004) Functional MRI of the lung using hyperpolarized 3-helium gas. J Magn Reson Imaging 20:540–554

Schreiber WG, Morbach AE, Stavngaard T, Gast KK, Herweling A, Sogaard LV et al (2005) Assessment of lung microstructure with magnetic resonance imaging of hyperpolarized Helium-3. Respir Physiol Neurobiol 148:23-42CrossRef

Heussel CP, Gast KK, Dahmen A, Morbach AE, Kauczor HU, Schreiber WG et al (2005) Hyperpolarized (3)helium gas for functional magnetic resonance imaging of the lung. Med Klin (Munich) 100:413–424CrossRef

Flors L, Mugler JP 3rd, de Lange EE, Miller GW, Mata JF, Tustison N et al (2016) Hyperpolarized gas magnetic resonance lung imaging in children and young adults. J Thorac Imaging 31:285–295CrossRef

Edelman RR, Hatabu H, Tadamura E, Li W, Prasad PV (1996) Noninvasive assessment of regional ventilation in the human lung using oxygen-enhanced magnetic resonance imaging. Nat Med 2:1236-1239CrossRef

Jakob PM, Wang T, Schultz G, Hebestreit H, Hebestreit A, Hahn D (2004) Assessment of human pulmonary function using oxygen-enhanced T(1) imaging in patients with cystic fibrosis. Magn Reson Med 51:1009–1016

Naish JH, Parker GJ, Beatty PC, Jackson A, Young SS, Waterton JC et al (2005) Improved quantitative dynamic regional oxygen-enhanced pulmonary imaging using image registration. Magn Reson Med 54:464–469CrossRef

10.

Brody AS, Klein JS, Molina PL, Quan J, Bean JA, Wilmott RW (2009) High-resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests. J Pediatr 145:32–38CrossRef

11.

Meyers CR, Blesh TE (1962) Measurement in physical education. Ronald Press, New York

12.

Zhang WJ, Niven RM, Young SS, Liu YZ, Parker GJ, Naish JH (2015) Dynamic oxygen-enhanced magnetic resonance imaging of the lung in asthma—initial experience. Eur J Radiol 84:318–326CrossRef

13.

Chen Q, Jakob PM, Griswold MA, Levin DL, Hatabu H, Edelman RR (1998) Oxygen enhanced MR ventilation imaging of the lung. MAGMA 7:153–161CrossRef

14.

Ohno Y, Hatabu H, Takenaka D, Adachi S, Van Cauteren M, Sugimura K (2001) Oxygen-enhanced MR ventilation imaging of the lung. AJR Am J Roentgenol 177:185–194CrossRef

15.

Ohno Y, Hatabu H, Takenaka D, Van Cauteren M, Fujii M, Sugimura K (2002) Dynamic oxygen-enhanced MRI reflects diffusing capacity of the lung. Magn Reson Med 47:1139–1144CrossRef

16.

Ramsey BW (1996) Management of pulmonary disease in patients with cystic fibrosis. N Engl J Med 335:179–188CrossRef

17.

Schaefer JF, Hector A, Schmidt K, Teufel M, Fleischer S, Graepler-Mainka U et al (2018) A semiquantitative MRI-Score can predict loss of lung function in patients with cystic fibrosis: Preliminary results. Eur Radiol 28:74–78CrossRef

18.

Ciet P, Bertolo S, Ros M, Andrinopoulou ER, Tavano V, Lucca F et al (2017) Detection and monitoring of lung inflammation in cystic fibrosis during respiratory tract exacerbation using diffusion-weighted magnetic resonance imaging. Eur Respir J 50(1). https://doi.org/10.1183/13993003.01437-2016 CrossRef

19.

Grasemann H, Ciet P, Amin R, McDonald N, Klingel M, Tiddens H et al (2017) Changes in magnetic resonance imaging scores and ventilation inhomogeneity in children with cystic fibrosis pulmonary exacerbations. Eur Respir J 50(2). https://doi.org/10.1183/13993003.00244-2017 CrossRef

Title: Volumetric dynamic oxygen-enhanced MRI (OE-MRI): comparison with CT Brody score and lung function in cystic fibrosis patients
Authors: K. Martini
C. M. Gygax
C. Benden
A. R. Morgan
G. J. M. Parker
T. Frauenfelder
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 10/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5383-5

At a glance: The STEP trials

Springer Medicine

Volumetric dynamic oxygen-enhanced MRI (OE-MRI): comparison with CT Brody score and lung function in cystic fibrosis patients

Abstract

Objectives

Methods

Results

Conclusions

Key points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key points

Please log in to get access to this content

Other articles of this Issue 10/2018

Correction to: Reference ranges of left ventricular structure and function assessed by contrast-enhanced cardiac MR and changes related to ageing and hypertension in a population-based study

Diagnostic performance of dual-energy CT for the detection of bone marrow oedema: a systematic review and meta-analysis

Preoperative localisation of pulmonary ground-glass opacity using medical adhesive before thoracoscopic resection

Diagnostic value of six MRI features for central neurocytoma

Accurate IVIM model-based liver lesion characterisation can be achieved with only three b-value DWI

Oesophageal squamous cell carcinoma: histogram-derived ADC parameters are not predictive of tumour response to chemoradiotherapy