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Ultrashort Echo-Time Magnetic Resonance Imaging Is a Sensitive Method for the Evaluation of Early Cystic Fibrosis Lung Disease.

ABSTRACT: RATIONALE:Recent advancements that have been made in magnetic resonance imaging (MRI) improve our ability to assess pulmonary structure and function in patients with cystic fibrosis (CF). A nonionizing imaging modality that can be used as a serial monitoring tool throughout life can positively affect patient care and outcomes. OBJECTIVES:To compare an ultrashort echo-time MRI method with computed tomography (CT) as a biomarker of lung structure abnormalities in young children with early CF lung disease. METHODS:Eleven patients with CF (mean age, 31.8?±?5.7 mo; median age, 33 mo; 7 male and 4 female) were imaged via CT and ultrashort echo-time MRI. Eleven healthy age-matched patients (mean age, 22.5?±?10.2 mo; median age, 23 mo; 5 male and 6 female) were imaged via ultrashort echo-time MRI. CT scans of 13 additional patients obtained for clinical indications not affecting the heart or lungs and interpreted as normal provided a CT control group (mean age, 24.1?±?11.7 mo; median age, 24 mo; 6 male and 7 female). Studies were scored by two experienced radiologists using a well-validated CF-specific scoring system for CF lung disease. MEASUREMENTS AND MAIN RESULTS:Correlations between CT and ultrashort echo-time MRI scores of patients with CF were very strong, with P values ?0.001 for bronchiectasis (r?=?0.96) and overall score (r?=?0.90), and moderately strong for bronchial wall thickening (r?=?0.62, P?=?0.043). MRI easily differentiated CF and control groups via a reader CF-specific scoring system. CONCLUSIONS:Ultrashort echo-time MRI detected structural lung disease in very young patients with CF and provided imaging data that correlated well with CT. By quantifying early CF lung disease without using ionizing radiation, ultrashort echo-time MRI appears well suited for pediatric patients requiring longitudinal imaging for clinical care or research studies. Clinical Trial registered with www.clinicaltrials.gov (NCT01832519).

SUBMITTER: Roach DJ

PROVIDER: S-EPMC5122478 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Ultrashort Echo-Time Magnetic Resonance Imaging Is a Sensitive Method for the Evaluation of Early Cystic Fibrosis Lung Disease.

Roach David J DJ Crémillieux Yannick Y Fleck Robert J RJ Brody Alan S AS Serai Suraj D SD Szczesniak Rhonda D RD Kerlakian Stephanie S Clancy John P JP Woods Jason C JC

Annals of the American Thoracic Society 20161101 11

<h4>Rationale</h4>Recent advancements that have been made in magnetic resonance imaging (MRI) improve our ability to assess pulmonary structure and function in patients with cystic fibrosis (CF). A nonionizing imaging modality that can be used as a serial monitoring tool throughout life can positively affect patient care and outcomes.<h4>Objectives</h4>To compare an ultrashort echo-time MRI method with computed tomography (CT) as a biomarker of lung structure abnormalities in young children with ...[more]

PMID: 27551814

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Project description:BackgroundA previous study demonstrated the feasibility of using 3D radial ultrashort echo time (UTE) oxygen-enhanced MRI (UTE OE-MRI) for functional imaging of healthy human lungs. The repeatability of quantitative measures from UTE OE-MRI needs to be established prior to its application in clinical research.PurposeTo evaluate repeatability of obstructive patterns in asthma and cystic fibrosis (CF) with UTE OE-MRI with isotropic spatial resolution and full chest coverage.Study typeVolunteer and patient repeatability.PopulationEighteen human subjects (five asthma, six CF, and seven normal subjects).Field strength/sequenceRespiratory-gated free-breathing 3D radial UTE (80 μs) sequence at 1.5T.AssessmentTwo 3D radial UTE volumes were acquired sequentially under normoxic and hyperoxic conditions. A subset of subjects underwent repeat acquisitions on either the same day or ≤15 days apart. Asthma and CF subjects also underwent spirometry. A workflow including deformable registration and retrospective lung density correction was used to compute 3D isotropic percent signal enhancement (PSE) maps. Median PSE (MPSE) and ventilation defect percent (VDP) of the lung were measured from the PSE map.Statistical testsThe relations between MPSE, VDP, and spirometric measures were assessed using Spearman correlations. The test-retest repeatability was evaluated using Bland-Altman analysis and intraclass correlation coefficients (ICC).ResultsVentilation measures in normal subjects (MPSE = 8.0%, VDP = 3.3%) were significantly different from those in asthma (MPSE = 6.0%, P = 0.042; VDP = 21.7%, P = 0.018) and CF group (MPSE = 4.5%, P = 0.0006; VDP = 27.2%, P = 0.002). MPSE correlated significantly with forced expiratory lung volume in 1 second percent predicted (ρ = 0.72, P = 0.017). The ICC of the test-retest VDP and MPSE were both ≥0.90. In all subject groups, an anterior/posterior gradient was observed with higher MPSE and lower VDP in the posterior compared to anterior regions (P ≤ 0.0021 for all comparisons).Data conclusion3D radial UTE OE-MRI supports quantitative differentiation of diseased vs. healthy lungs using either whole lung VDP or MPSE with excellent test-retest repeatability.Level of evidence2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1287-1297.

Project description:Chest computed tomography (CT) is routinely performed to evaluate intrathoracic metastasis in patients with breast cancer, but radiation exposure and its potential carcinogenic risks are major drawbacks. Furthermore, pulmonary imaging by magnetic resonance imaging (MRI) is limited by low proton density, rapid signal decay, and sensitivity to respiratory and cardiac motions in lung tissue. Recently, a respiratory gating spiral three-dimensional (3D) ultrashort echo time (UTE) volume interpolated breath-hold examination (VIBE) sequence for lung MRI provides high spatial-resolution images with reasonable scan times. Our objective was to investigate the feasibility of chest spiral 3D UTE VIBE MRI to detect intrathoracic metastasis in breast cancer patients. This retrospective study of a prospectively collected database was conducted between February and July 2019 after institutional review board approval. All participants provided informed consent for MRI scans. Ninety-three female patients with breast cancer were retrospectively enrolled and underwent preoperative breast MRI, including a chest spiral 3D UTE VIBE sequence. Two chest radiologists evaluated image qualities of intrapulmonary vessels and bronchial wall visibilities, the presence of pulmonary nodules, significant lymph nodes (LNs), and other lung abnormalities on spiral 3D UTE magnetic resonance (MR) images and compared them using chest CT as a reference standard. Intrapulmonary vessels and bronchial walls were visible up to sub-subsegmental and sub-subsegmental levels, respectively, on spiral 3D UTE MR images, and better than fair quality was obtained for artifact/noise and overall image quality for 95.7% and 98.9% of the patients, respectively. The overall detection rate for pulmonary nodules was 62.8% (59/94). Furthermore, 59 of the 81 solid nodules detected by CT were detected by spiral 3D UTE MRI (72.8%), and 31 of the 33 solid nodules (≥5 mm in diameter) detected by CT were identified by spiral 3D UTE MRI (93.9%). Significant LNs in the axillary area were similarly detected by spiral 3D UTE MRI and chest CT. Preoperative breast MRI with a chest spiral 3D UTE sequence could be used to evaluate breast cancer and axillary LNs and intrathoracic metastasis simultaneously and offers a potential alternative to chest CT for breast cancer patients without additional radiation exposure.

Dataset Information

Ultrashort Echo-Time Magnetic Resonance Imaging Is a Sensitive Method for the Evaluation of Early Cystic Fibrosis Lung Disease.

Publications

Ultrashort Echo-Time Magnetic Resonance Imaging Is a Sensitive Method for the Evaluation of Early Cystic Fibrosis Lung Disease.

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