Proton Magnetic Resonance Imaging to Stage Activity of Interstitial Lung Disease

McFadden, Robin G.; Carr, Thomas J.; Wood, Tom E.

doi:10.1378/chest.92.1.31

Cited by 45 publications

(14 citation statements)

References 30 publications

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“…This is the first study, as far as the authors know, studying the MRI extent in SSc ILD. MRI in ILD has been primarily used to assess the activity of the disease [6,7,[9][10][11]18]; however, the extent of ILD has been scarcely studied with this technique [8]. Moreover, SSc patients were barely represented in previous reports [6][7][8][9][10][11]18].…”

Section: Discussionmentioning

confidence: 99%

“…Alternative imaging methods that do not involve ionizing radiation, such as magnetic resonance imaging (MRI), have been proposed to study patients with ILD. Particularly, T2-weighted MRI has been described to detect ILD-associated parenchymal abnormalities and differentiate between active inflammation and fibrosis, especially if it is enhanced using MRI contrast or high magnetic fields [6][7][8][9][10][11]. No studies have assessed, as far as the authors know, the utility of MRI chest imaging compared with HRCT to study the extent of lung involvement in patients with ILD due to SSc.…”

Section: Introductionmentioning

confidence: 99%

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Fast 1.5 T chest MRI for the assessment of interstitial lung disease extent secondary to systemic sclerosis

et al. 2016

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This study aims to evaluate the utility of magnetic resonance imaging (MRI) to assess interstitial lung disease (ILD) extent in patients with systemic sclerosis (SSc). Patients with SSc and varying degrees of ILD with a high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), and a chest MRI containing an ultrafast SE sequence performed less than 1 year apart were included in the study. Wells global disease extent and Goh's staging algorithm were used to measure and categorize ILD both for MRI and HRCT. Correlation and diagnostic performance of MRI compared with HRCT and PFTs were calculated. Eighteen SSc patients were studied. MRI showed a good performance to detect ILD (AUC = 0.96) and was correlated with forced vital capacity (r = -0.60, p = 0.01), diffusing capacity of the lung for carbon monoxide (r = -0.79, p = 0.04), and also with HRCT (r = 0.85, p < 0.001), but MRI extent values were consistently lower than HRCT and, thus, not directly comparable. Goh's algorithm using HRCT and transformed to be used with MRI showed a good agreement (kappa = 0.73, p < 0.001) and MRI-measured ILD extent presented good intra-observer (ICC = 0.86) and inter-observer (ICC = 0.90) reliability. In SSc patients, MRI proved to be a good technique to detect and categorize ILD extent compared with HRCT, suggesting that it may be a valuable x-ray sparing technique for selected cases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fast 1.5 T chest MRI for the assessment of interstitial lung disease extent secondary to systemic sclerosis

et al. 2016

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“…There have been individual studies on the detection of pulmonary metastases, on the evaluation of the activity of inflammatory parenchymal diseases of the lung, on MR angiography of pulmonary vessels and on pulmonary perfusion and ventilation using a wide range of different MRI techniques, including gradient echo sequences, successfully [3][4][5][6][7][8][9][10][11]. However, all of these examinations were performed at field strengths of 1.5 T or lower.…”

Section: Discussionmentioning

confidence: 99%

Lung MRI at 3.0 T: a comparison of helical CT and high-field MRI in the detection of diffuse lung disease

et al. 2004

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The purpose of this study was to evaluate the feasibility of high-field magnetic resonance imaging (MRI) of the lung using a T2-weighted fast-spin echo (TSE) sequence. Comparison was made with helical computed tomography CT findings in patients with diffuse pulmonary diseases. Prospective segment-wise analysis of high-field MR imaging findings in 15 patients with diffuse pulmonary diseases was made using helical CT and HRCT as the standard of reference. The MR studies were performed on a 3.0-T whole body system (Intera 3T, Philips Medical Systems) using a T2w TSE sequence with respiratory and cardiac gating (TE 80 ms TR 1,500-2,500 ms; turbo factor 17; 22 slices with 7/2-mm slice thickness and gap; 256x192 matrix). MR artifacts were graded on a three-point scale (low, moderate, high). Lung MR studies were prospectively analyzed segment-by-segment and diagnosed as healthy or pathological; results were compared with helical CT findings. In all 15 patients, MR imaging of the lung was successful. All 15 MR studies were compromised by artifacts; however, the severity of these artifacts was classified as low or moderate in 8/15, respectively, 7/15 cases. A total of 143/285 lung segments showed diffuse lung disease in helical CT. With MRI, 133 of these 143 segments (93%) were judged to be diseased. The ten segments that received false negative MR diagnoses displayed non-acute pulmonary lesions with inherently low proton density (scars, granulomas). MRI at 3.0 T can detect diffuse pulmonary disease with a high sensitivity. Based on this experience, further pulmonary studies with high-field systems appear justified and promising.

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“…However, data are lacking and relatively old in sarcoidosis [111][112][113][114][115] using unenhanced T1 and T2-weighted MRI. GAETA et al [116] first used gadolinium enhanced thoracic MRI in a cohort of DLDs, including 10 patients with sarcoidosis, and showed enhancement of pulmonary lesions in five out of seven patients with active disease [116].…”

Section: Other Imaging Techniquesmentioning

confidence: 99%

Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

et al. 2012

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Imaging has a prominent role in the assessment of sarcoidosis diagnosis and outcome, which are extremely variable. Chest radiography staging helps predict the probability of spontaneous remission, and stage IV is associated with higher mortality. However, the reproducibility of reading is poor and changes in radiography and lung function are inconsistently correlated, which may be problematic for the monitoring of disease and treatment response. Chest computed tomography (CT) makes a great diagnostic contribution in difficult cases. Bilateral hilar lymphadenopathy with peri-lymphatic micronodular pattern is highly specific for sarcoidosis. CT is important for the investigation of pulmonary complications, including aspergilloma and pulmonary hypertension. CT improves the yield of bronchoscopy for obtaining a positive endobronchial or transbronchial biopsy. CT findings may also discriminate between active inflammation and irreversible fibrosis, with occasional influence on therapeutic decisions. Three CT patterns of fibrotic sarcoidosis are identified, with different functional profiles: predominant bronchial distortion is associated with obstruction; honeycombing is associated with restriction and lower diffusing capacity of the lung for carbon monoxide; whereas functional impairment is relatively minor with linear pattern. The clinical impact of correlations between CT severity scores and functional impairment is uncertain, except for its utility elucidating the mechanisms of airflow limitation, which include bronchial distortion, peribronchovascular thickening, air-trapping and bronchial compression by lymphadenopathy.

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Proton Magnetic Resonance Imaging to Stage Activity of Interstitial Lung Disease

Cited by 45 publications

References 30 publications

Fast 1.5 T chest MRI for the assessment of interstitial lung disease extent secondary to systemic sclerosis

Fast 1.5 T chest MRI for the assessment of interstitial lung disease extent secondary to systemic sclerosis

Lung MRI at 3.0 T: a comparison of helical CT and high-field MRI in the detection of diffuse lung disease

Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

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