Delayed contrast dynamics as marker of regional impairment in pulmonary fibrosis using 5D MRI - a pilot study.
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Date
2020-09-01ICR Author
Author
Buzan, MT
Wetscherek, A
Rank, CM
Kreuter, M
Heussel, CP
Kachelrieß, M
Dinkel, J
Type
Journal Article
Metadata
Show full item recordAbstract
OBJECTIVE: To analyse delayed contrast dynamics of fibrotic lesions in interstitial lung disease (ILD) using five dimensional (5D) MRI and to correlate contrast dynamics with disease severity. METHODS: 20 patients (mean age: 71 years; M:F, 13:7), with chronic fibrosing ILD: n = 12 idiopathic pulmonary fibrosis (IPF) and n = 8 non-IPF, underwent thin-section multislice CT as part of the standard diagnostic workup and additionally MRI of the lung. 2 min after contrast injection, a radial gradient echo sequence with golden-angle spacing was acquired during 5 min of free-breathing, followed by 5D image reconstruction. Disease was categorized as severe or non-severe according to CT morphological regional severity. For each patient, 10 lesions were analysed. RESULTS: IPF lesions showed later peak enhancement compared to non-IPF (severe: p = 0.01, non-severe: p = 0.003). Severe lesions showed later peak enhancement compared to non-severe lesions, in non-IPF (p = 0.04), but not in IPF (p = 0.35). There was a tendency towards higher accumulation and washout rates in IPF compared to non-IPF in non-severe disease. Severe lesions had lower washout rate than non-severe ones in both IPF (p = 0.003) and non-IPF (p = 0.005). Continuous contrast agent accumulation, without washout, was found only in IPF lesions. CONCLUSIONS: Contrast agent dynamics are influenced by type and severity of pulmonary fibrosis, which might enable a more thorough characterisation of disease burden. The regional impairment is of particular interest in the context of antifibrotic treatments and was characterised using a non-invasive, non-irradiating, free-breathing method. ADVANCES IN KNOWLEDGE: Delayed contrast enhancement patterns allow the assessment of regional lung impairment which could represent different disease stages or phenotypes in ILD.
Collections
Subject
Humans
Lung Diseases, Interstitial
Pulmonary Fibrosis
Connective Tissue Diseases
Organometallic Compounds
Contrast Media
Magnetic Resonance Imaging
Vital Capacity
Severity of Illness Index
Prospective Studies
Pilot Projects
Respiration
Principal Component Analysis
Time Factors
Image Processing, Computer-Assisted
Aged
Middle Aged
Female
Male
Idiopathic Interstitial Pneumonias
Idiopathic Pulmonary Fibrosis
Multidetector Computed Tomography
Research team
Radiotherapy Physics Modelling
Radiotherapy Physics Modelling
Language
eng
Date accepted
23-06-20
License start date
2020-07-08
Citation
The British journal of radiology, 2020, 93 (1113), pp. 20190121 - ?
Publisher
BRITISH INST RADIOLOGY