Automated MR-based lung volume segmentation in population-based whole-body MR imaging: correlation with clinical characteristics, pulmonary function testing and obstructive lung disease
Whole-body MR imaging is increasingly utilised; although for lung dedicated sequences are often not included, the chest is typically imaged. Our objective was to determine the clinical utility of lung volumes derived from non-dedicated MRI sequences in the population-based KORA-FF4 cohort study.
400 subjects (56.4 ± 9.2 years, 57.6% males) underwent whole-body MRI including a coronal T1-DIXON-VIBE sequence in inspiration breath-hold, originally acquired for fat quantification. Based on MRI, lung volumes were derived using an automated framework and related to common predictors, pulmonary function tests (PFT; spirometry and pulmonary gas exchange, n = 214) and obstructive lung disease.
MRI-based lung volume was 4.0 ± 1.1 L, which was 64.8 ± 14.9% of predicted total lung capacity (TLC) and 124.4 ± 27.9% of functional residual capacity. In multivariate analysis, it was positively associated with age, male, current smoking and height. Among PFT indices, MRI-based lung volume correlated best with TLC, alveolar volume and residual volume (RV; r = 0.57 each), while it was negatively correlated to FEV1/FVC (r = 0.36) and transfer factor for carbon monoxide (r = 0.16). Combining the strongest PFT parameters, RV and FEV1/FVC remained independently and incrementally associated with MRI-based lung volume (β = 0.50, p = 0.04 and β = – 0.02, p = 0.02, respectively) explaining 32% of the variability. For the identification of subjects with obstructive lung disease, height-indexed MRI-based lung volume yielded an AUC of 0.673–0.654.
Lung volume derived from non-dedicated whole-body MRI is independently associated with RV and FEV1/FVC. Furthermore, its moderate accuracy for obstructive lung disease indicates that it may be a promising tool to assess pulmonary health in whole-body imaging when PFT is not available.
• Although whole-body MRI often does not include dedicated lung sequences, lung volume can be automatically derived using dedicated segmentation algorithms
• Lung volume derived from whole-body MRI correlates with typical predictors and risk factors of respiratory function including smoking and represents about 65% of total lung capacity and 125% of the functional residual capacity
• Lung volume derived from whole-body MRI is independently associated with residual volume and the ratio of forced expiratory volume in 1 s to forced vital capacity and may allow detection of obstructive lung disease
KeywordsMagnetic resonance imaging Whole-body imaging Computer-assisted image analysis Pulmonary function test Obstructive lung disease
Area under the curve
Body mass index
Body surface area
COPD assessment tool
Chronic obstructive lung disease
Forced expiratory flow 25–75%
Forced expiratory volume in 1 s
Functional reserve capacity
Forced vital capacity
Magnetic resonance imaging
Pulmonary function testing
Receiver operating characteristic
Total lung capacity
Transfer factor of the lung for carbon monoxide
This study was funded by German Research Foundation (Bonn, Germany) grant BA 4233/4 1 and SCHL 2174/1-2, and German Centre for Cardiovascular Disease Research (Berlin, Germany) grants 81X2600209 and 81X2600214.
Compliance with ethical standards
The scientific guarantor of this publication is Christopher L. Schlett, MD MPH.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional review board approval was obtained.
Study subjects or cohorts overlap
Some study subjects or cohorts have been previously reported in Bamberg et al Subclinical disease burden as assessed by whole-body MRI in subjects with prediabetes, subjects with diabetes, and normal control subjects from the general population: the KORA-MRI study. Diabetes. 2017 Jan;66(1):158–169.
• cross-sectional study/observational
• performed at one institution
- 1.GBD 2015 Chronic Respiratory Disease Collaborators (2017) Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med 5:691–706CrossRefGoogle Scholar
- 3.Jenkins C (2008) COPD management. Part I. Strategies for managing the burden of established COPD. Int J Tuberc Lung Dis 12:586–594Google Scholar
- 8.Ekinci A, Yücel Uçarkuş T, Okur A, Öztürk M, Doğan S (2017) MRI of pneumonia in immunocompromised patients: comparison with CT. Diagn Interv Radiol 23:22–28Google Scholar
- 25.Holle R, Happich M, Löwel H, Wichmann HE; MONICA/KORA Study Group (2005) KORA–a research platform for population based health research. Gesundheitswesen 67(Suppl 1):S19–S25Google Scholar
- 33.Graham BL, Brusasco V, Burgos F et al (2017) 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J 49Google Scholar