Reproducibility of pulmonary magnetic resonance angiography in adults with muco-obstructive pulmonary disease

Background Recent studies support magnetic resonance angiography (MRA) as a diagnostic tool for pulmonary arterial disease. Purpose To determine MRA image quality and reproducibility, and the dependence of MRA image quality and reproducibility on disease severity in patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). Material and Methods Twenty patients with COPD (mean age 66.5 ± 8.9 years; FEV1% = 42.0 ± 13.3%) and 15 with CF (mean age 29.3 ± 9.3 years; FEV1% = 66.6 ± 15.8%) underwent morpho-functional chest magnetic resonance imaging (MRI) including time-resolved MRA twice one month apart (MRI1, MRI2), and COPD patients underwent non-contrast computed tomography (CT). Image quality was assessed visually using standardized subjective 5-point scales. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured by regions of interest. Disease severity was determined by spirometry, a well-evaluated chest MRI score, and by computational CT emphysema index (EI) for COPD. Results Subjective image quality was diagnostic for all MRA at MRI1 and MRI2 (mean score = 4.7 ± 0.6). CNR and SNR were 4 43.8 ± 8.7 and 50.5 ± 8.7, respectively. Neither image quality score nor CNR or SNR correlated with FEV1% or chest MRI score for COPD and CF (r = 0.239–0.248). CNR and SNR did not change from MRI1 to MRI2 (P = 0.434–0.995). Further, insignificant differences in CNR and SNR between MRA at MRI1 and MRI2 did not correlate with FEV1% nor chest MRI score in COPD and CF (r = −0.238–0.183), nor with EI in COPD (r = 0.100–0.111). Conclusion MRA achieved diagnostic quality in COPD and CF patients and was highly reproducible irrespective of disease severity. This supports MRA as a robust alternative to CT in patients with underlying muco-obstructive lung disease.

[1]  P. Dargan,et al.  Gadolinium-based contrast agents – what is the evidence for ‘gadolinium deposition disease’ and the use of chelation therapy? , 2020, Clinical toxicology.

[2]  H. Kauczor,et al.  Quantitative CT detects progression in COPD patients with severe emphysema in a 3-month interval , 2020, European Radiology.

[3]  Meilan K. Han,et al.  Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019 , 2019, European Respiratory Journal.

[4]  Bertram J Jobst,et al.  Longitudinal airway remodeling in active and past smokers in a lung cancer screening population , 2018, European Radiology.

[5]  Marleen de Bruijne,et al.  Technical challenges of quantitative chest MRI data analysis in a large cohort pediatric study , 2018, European Radiology.

[6]  Jürgen Biederer,et al.  Magnetic resonance angiography for the primary diagnosis of pulmonary embolism: A review from the international workshop for pulmonary functional imaging , 2018, World journal of radiology.

[7]  H. Kauczor,et al.  Morphologic Characterization of Pulmonary Nodules With Ultrashort TE MRI at 3T. , 2018, AJR. American journal of roentgenology.

[8]  A. Torbicki,et al.  The pathophysiology of chronic thromboembolic pulmonary hypertension , 2017, European Respiratory Review.

[9]  J. Wedzicha,et al.  Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary , 2017, European Respiratory Journal.

[10]  M Puderbach,et al.  Imaging of Cystic Fibrosis Lung Disease and Clinical Interpretation , 2016, RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren.

[11]  M. Humbert,et al.  A global view of pulmonary hypertension. , 2016, The Lancet. Respiratory medicine.

[12]  Pascal J. Kieslich,et al.  Gadolinium retention in the dentate nucleus and globus pallidus is dependent on the class of contrast agent. , 2015, Radiology.

[13]  S. Sleijfer,et al.  Diagnostic and therapeutic ionizing radiation and the risk of a first and second primary breast cancer, with special attention for BRCA1 and BRCA2 mutation carriers: a critical review of the literature. , 2015, Cancer treatment reviews.

[14]  H. Kauczor,et al.  Magnetic resonance imaging detects changes in structure and perfusion, and response to therapy in early cystic fibrosis lung disease. , 2014, American journal of respiratory and critical care medicine.

[15]  Daisuke Takenaka,et al.  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. , 2014, Radiology.

[16]  Kevin M. Johnson,et al.  Optimized 3D ultrashort echo time pulmonary MRI , 2013, Magnetic resonance in medicine.

[17]  B. Yeh,et al.  Diagnostic accuracy of three-dimensional contrast-enhanced MR angiography at 3-T for acute pulmonary embolism detection: comparison with multidetector CT angiography. , 2013, International journal of cardiology.

[18]  M. Repplinger,et al.  Effectiveness of MR angiography for the primary diagnosis of acute pulmonary embolism: Clinical outcomes at 3 months and 1 year , 2013, Journal of magnetic resonance imaging : JMRI.

[19]  M. Hamilton,et al.  Intravenous contrast medium administration at 128 multidetector row CT pulmonary angiography: bolus tracking versus test bolus and the implications for diagnostic quality and effective dose. , 2012, Clinical radiology.

[20]  K. P. Kim,et al.  Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study , 2012, The Lancet.

[21]  M. Puderbach,et al.  MRI of the lung (1/3): methods , 2012, Insights into Imaging.

[22]  Annette Kopp-Schneider,et al.  Morphologic and functional scoring of cystic fibrosis lung disease using MRI. , 2012, European Journal of Radiology.

[23]  S. Ley,et al.  Diagnostic performance of state-of-the-art imaging techniques for morphological assessment of vascular abnormalities in patients with chronic thromboembolic pulmonary hypertension (CTEPH) , 2012, European Radiology.

[24]  M. Puderbach,et al.  MRI of the lung (2/3). Why … when … how? , 2012, Insights into Imaging.

[25]  K. Jablonski,et al.  Factors in the technical quality of gadolinium enhanced magnetic resonance angiography for pulmonary embolism in PIOPED III , 2012, The International Journal of Cardiovascular Imaging.

[26]  L. Goodman,et al.  Diagnosis and Management of Isolated Subsegmental Pulmonary Embolism: Review and Assessment of the Options , 2012, Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis.

[27]  H. Sostman,et al.  Gadolinium-Enhanced Magnetic Resonance Angiography for Pulmonary Embolism , 2010, Annals of Internal Medicine.

[28]  G. Beluffi,et al.  MRI of the lung , 2010, La radiologia medica.

[29]  H. Sostman,et al.  Methods of Prospective Investigation of Pulmonary Embolism Diagnosis III (PIOPED III). , 2008, Seminars in nuclear medicine.

[30]  Martine Remy-Jardin,et al.  Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner Society. , 2007, Radiology.

[31]  Tim Leiner,et al.  Maximizing contrast‐to‐noise ratio in ultra‐high resolution peripheral MR angiography using a blood pool agent and parallel imaging , 2007, Journal of magnetic resonance imaging : JMRI.

[32]  F. Rybicki,et al.  Time-resolved MR angiography: a primary screening examination of patients with suspected pulmonary embolism and contraindications to administration of iodinated contrast material. , 2007, AJR. American journal of roentgenology.

[33]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[34]  L. Goodman,et al.  Small pulmonary emboli: what do we know? , 2005, Radiology.

[35]  H. Kauczor,et al.  Chronic thromboembolic pulmonary hypertension: pre- and postoperative assessment with breath-hold MR imaging techniques. , 2004, Radiology.

[36]  Y. Ohno,et al.  MR angiography with sensitivity encoding (SENSE) for suspected pulmonary embolism: comparison with MDCT and ventilation-perfusion scintigraphy. , 2004, AJR. American journal of roentgenology.

[37]  M. Oudkerk,et al.  Comparison of contrast-enhanced magnetic resonance angiography and conventional pulmonary angiography for the diagnosis of pulmonary embolism: a prospective study , 2002, The Lancet.

[38]  Todd B. Parrish,et al.  Impact of signal‐to‐noise on functional MRI , 2000 .

[39]  A. Khalil,et al.  Pulmonary arteriovenous malformations. , 2000, Chest.

[40]  H. Fuchs,et al.  Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. The Pulmozyme Study Group. , 1994, The New England journal of medicine.

[41]  Shipboard ScientiÞc Party.  3. Methods , 1993, Framing Prior Consultation in Brazil.

[42]  J E Cotes,et al.  Lung volumes and forced ventilatory flows , 1993, European Respiratory Journal.

[43]  J. Roca,et al.  Standardization of the measurement of transfer factor (diffusing capacity). Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. , 1993, The European respiratory journal. Supplement.

[44]  J E Cotes,et al.  Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. , 1993, The European respiratory journal. Supplement.

[45]  J. Leipsic,et al.  Reduced iodine load at CT pulmonary angiography with dual-energy monochromatic imaging: comparison with standard CT pulmonary angiography--a prospective randomized trial. , 2012, Radiology.

[46]  Hans-Ulrich Kauczor,et al.  MRI of the lung: state of the art. , 2012, Diagnostic and interventional radiology.