Ultrashort Echo-Time Magnetic Resonance Imaging Sequence in the Assessment of Systemic Sclerosis-Interstitial Lung Disease

Abstract

Purpose: To test respiratory-triggered ultrashort echo-time (UTE) Spiral VIBE-MRI sequence in systemic sclerosis-interstitial lung disease assessment compared with computed tomography (CT). Material and Methods: Fifty four SSc patients underwent chest CT and UTE (1.5 T). Two radiologists, independently and in consensus, verified ILD presence/absence and performed a semiquantitative analysis (sQA) of ILD, ground-glass opacities (GGO), reticulations and honeycombing (HC) extents on both scans. A CT software quantitative texture analysis (QA) was also performed. For ILD detection, intra-/inter-reader agreements were computed with Cohen K coefficient. UTE sensitivity and specificity were assessed. For extent assessments, intra-/inter-reader agreements and UTE performance against CT were computed by Lin’s concordance coefficient (CCC). Results: Three UTE were discarded for low quality, 51 subjects were included in the study. Of them, 42 QA segmentations were accepted. ILD was diagnosed in 39/51 CT. UTE intra-/inter-reader K in ILD diagnosis were 0.56 and 0.26. UTE showed 92.8% sensitivity and 75.0% specificity. ILD, GGO, and reticulation extents were 14.8%, 7.7%, and 7.1% on CT sQA and 13.0%, 11.2%, and 1.6% on CT QA. HC was <1% and not further considered. UTE intra-/inter-reader CCC were 0.92 and 0.89 for ILD extent and 0.84 and 0.79 for GGO extent. UTE RET extent intra-/inter-reader CCC were 0.22 and 0.18. UTE ILD and GGO extents CCC against CT sQA and QA were ≥0.93 and ≥0.88, respectively. RET extent CCC were 0.35 and 0.22 against sQA and QA, respectively. Conclusion: UTE Spiral VIBE-MRI sequence is reliable in assessing ILD and GGO extents in systemic sclerosis-interstitial lung disease patients.

Systemic sclerosis: one year in review 2022

“…Lung ultrasound (LUS) and MRI were recently proposed for screening and follow-up in ILD-SSc patients (71). The UTE MRI sequence was tested in 54 patients with SSc, showed high sensitivity (92.8%) and specificity (75.0%), and proved reliable in assessing ILD and the extent of ground-glass opacities in patients with SSc and ILD (72). LUS emerged as a safe and cheap imaging technique for the evaluation of ILD through the assessment of B-lines and pleural line alterations.…”

“…• Radiomics and lung ultrasound (LUS) are precise, sensitive, and specific tools able to improve the detection and the characterisation of SSc-ILD severity (65,66,72,73).…”

Management of respiratory tract exacerbations in people with cystic fibrosis: Focus on imaging

“…Nevertheless, recently developed zero echo time or ultrashort echo time (ZTE and UTE) sequences, which are currently the MRI sequences with the best resolution and signal-to-noise ratio (SNR) ( Figure 8 ), were tested with promising results in diffuse lung disease and CF ( 84 , 86 , 87 ). While these sequences allow sub-millimetric isotropic voxel resolution ( 88 ), they are limited by a long acquisition time, which are usually around 10 min ( 86 ), compared with the few seconds or less of the CT scan. Moreover, in terms of spatial resolution, MRI still does not match CT performance, with best voxel size for MRI of 0.86 mm 3 against the current 0.2 mm 3 capability of new Photon Counting CTs ( 7 , 88 ).…”

Feasibility of chest spiral 3D ultrashort echo time magnetic resonance imaging for intrathoracic metastasis work-up in breast cancer

“…The recent development of the ultrashort echo time (UTE) MRI sequence enables lung MRI to be used in clinical practice ( 4 - 13 ), but lung MRI is disadvantaged by a long scan time due to inefficient k-space coverage ( 4 , 6 , 14 ). To overcome this limitation, we applied three-dimensional (3D) stack-of-spirals (spiral) acquisition to improve readout efficiency ( 15 - 17 ).…”