MR Quantitative Equilibrium Signal Mapping: A Reliable Alternative to CT in the Assessment of Emphysema in Patients with Chronic Obstructive Pulmonary Disease

Zhang, Weijuan; Cristinacce, Penny L. Hubbard; Bondesson, Eva; Nordenmark, Lars H.; Young, Simon S.; Liu, Yuzhen; Singh, Dave; Naish, Josephine H.; Parker, Geoffrey

doi:10.1148/radiol.14132953

Cited by 11 publications

(20 citation statements)

References 38 publications

(50 reference statements)

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“…Moreover, COPD is the third leading cause of death worldwide [1]. There is loss of interstitial lung parenchyma and connective tissue support for the bronchi in emphysema.…”

Section: Discussionmentioning

confidence: 99%

“…The distance marker of 0.5 cm (marked as [1,2]) can be seen as a control that the ROI is drawn exactly in 0.5 cm distance to the segment bronchus offspring …”

Section: Quantitative Ct Analysis Of Lobar Lung Volumesmentioning

confidence: 99%

“…The effect on patients' quality of life is enormous with COPD representing one of the leading causes of morbidity and mortality worldwide [1]. In particular, emphysema, defined as destruction of interstitial lung parenchyma, is irreversible and mainly responsible for respiratory failure.…”

Section: Introductionmentioning

confidence: 99%

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Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests

et al. 2015

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“…Moreover, COPD is the third leading cause of death worldwide [1]. There is loss of interstitial lung parenchyma and connective tissue support for the bronchi in emphysema.…”

Section: Discussionmentioning

confidence: 99%

“…The distance marker of 0.5 cm (marked as [1,2]) can be seen as a control that the ROI is drawn exactly in 0.5 cm distance to the segment bronchus offspring …”

Section: Quantitative Ct Analysis Of Lobar Lung Volumesmentioning

confidence: 99%

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Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests

et al. 2015

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“…Chronic obstructive pulmonary disease (COPD) is one of the most common pulmonary diseases in the western world and one of the leading causes of death (1). It is defined by airflow obstruction through emphysema or airway narrowing or their combination (2).…”

Section: Introductionmentioning

confidence: 99%

Segmental bronchi collapsibility: computed tomography-based quantification in patients with chronic obstructive pulmonary disease and correlation with emphysema phenotype, corresponding lung volume changes and clinical parameters

et al. 2016

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Background: Global pulmonary function tests lack region specific differentiation that might influence therapy in severe chronic obstructive pulmonary disease (COPD) patients. Therefore, the aim of this work was to assess the degree of expiratory 3 rd generation bronchial lumen collapsibility in patients with severe COPD using chest-computed tomography (CT), to evaluate emphysema-phenotype, lobar volumes and correlate results with pulmonary function tests.Methods: Thin-slice chest-CTs acquired at end-inspiration & end-expiration in 42 COPD GOLD IV patients (19 females, median-age: 65.9 y) from November 2011 to July 2014 were re-evaluated. The crosssectional area of all segmental bronchi was measured 5 mm below the bronchial origin in both examinations.Lung lobes were semi-automatically segmented, volumes calculated at end-inspiratory and end-expiratory phase and visually defined emphysema-phenotypes defined. Results of CT densitometry were compared with lung functional tests including forced expiratory volume at 1 s (FEV 1 ), total lung capacity (TLC), vital capacity (VC), residual volume (RV), diffusion capacity parameters and the maximal expiratory flow rates (MEFs).Results: Mean expiratory bronchial collapse was 31%, stronger in lobes with homogenous (38.5%) vs.heterogeneous emphysema-phenotype (27.8%, P=0.014). The mean lobar expiratory volume reduction was comparable in both emphysema-phenotypes (volume reduction 18.6%±8.3% in homogenous vs.17.6%±16.5% in heterogeneous phenotype). The degree of bronchial lumen collapsibility, did not correlate with expiratory volume reduction. MEF 25 correlated weakly with 3 rd generation airway collapsibility (r=0.339, P=0.03). All patients showed a concentric expiratory reduction of bronchial cross-sectional area.Conclusions: Changes in collapsibility of 3 rd generation bronchi in COPD grade IV patients is significantly lower than that in the trachea and the main bronchi. Collapsibility did not correlate with the reduction in lung volume but was significantly higher in lobes with homogeneous vs. heterogeneous emphysema phenotype. Changes in the 3 rd generation bronchial calibres between inspiration and expiration are not predictive for the degree of small airway collapsibility and related airflow limitation.

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“…2 However, certain pathologies such as chronic obstructive pulmonary disease (COPD), asthma, and cystic fibrosis may manifest themselves in reduced signal from the lungs due to destruction of lung tissue and airways. 3,4 Structural imaging of the lung parenchyma is challenging due to the extremely short T Ã 2 of lung, the low proton density, and the possibility of motion-related artifacts on relatively longer MRI scans. Standard sequences based on gradient echo and spin-echo need to be used in conjunction with gadoliniumbased contrast agents to improve the signal-to-noise ratio (SNR).…”

mentioning

confidence: 99%

Evaluation of optimized breath‐hold and free‐breathing 3D ultrashort echo time contrast agent‐free MRI of the human lung

Gai

Agarwal

Evers

et al. 2015

Magnetic Resonance Imaging

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Purpose To evaluate an optimized stack of radials ultrashort echo time (UTE) three-dimensional MRI sequence for breath-hold and free breathing imaging of the human lung. Methods A 3D stack of ultrashort echo time radials trajectory was optimized for coronal and axial lower resolution breath-hold and higher resolution free breathing scans using Bloch simulations. The sequence was evaluated in ten volunteers, without the use contrast agents. SNR mean and 95% confidence interval were determined from separate signal and noise images in a semi-automated fashion. The four scanning schemes were evaluated for significant differences in image quality using the Student’s t-test. Ten clinical patients were scanned with the sequence and findings were compared with concomitant CT in nine patients. Breath-hold 3D spokes images were compared with 3D stack of radials in five volunteers. Mann-Whitney U test was performed to test significance in both cases. Results Breath-hold imaging of the entire lung in volunteers was performed with SNR (mean = 42.5 [CI]: 35.5 – 49.5; mean = 34.3 [CI]: 28.6 – 40) in lung parenchyma for coronal and axial scans respectively, which can be used as a quick scout scan. Longer respiratory triggered free breathing scan enabled high resolution UTE scanning with mean SNR of 14.2 ([CI]: 12.9 – 15.5) and 9.2 ([CI]: 8.2 – 10.2) for coronal and axial scans, respectively. Axial free breathing scans showed significantly higher image quality (P = 0.008) than the three other scanning schemes. The mean score for comparison with CT was 1.67 (score 0: N = 0; 1: N = 3; 2: N = 6). There was no significant difference between CT and MRI (P = 0.25). 3D stack of radials images were significantly better than 3D spokes images (P < 0.001). Conclusion The optimized 3D stack of radials trajectory was shown to provide high quality MR images of the lung parenchyma without the use of MRI contrast agents. The sequence may offer the possibility of breath-hold imaging and provides greater flexibility in trading off slice thickness and parallel imaging for scan time.

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MR Quantitative Equilibrium Signal Mapping: A Reliable Alternative to CT in the Assessment of Emphysema in Patients with Chronic Obstructive Pulmonary Disease

Abstract: Lung MR qS0 mapping may be a reliable noncontrast nonradiation alternative to CT in the assessment of emphysema in patients with COPD.

Cited by 11 publications

References 38 publications

Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests

Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests

Segmental bronchi collapsibility: computed tomography-based quantification in patients with chronic obstructive pulmonary disease and correlation with emphysema phenotype, corresponding lung volume changes and clinical parameters

Evaluation of optimized breath‐hold and free‐breathing 3D ultrashort echo time contrast agent‐free MRI of the human lung

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