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Volumetric dynamic oxygen-enhanced MRI (OE-MRI): comparison with CT Brody score and lung function in cystic fibrosis patients

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A Correction to this article was published on 12 June 2018

This article has been updated

Abstract

Objectives

To demonstrate, in patients with cystic fibrosis (CF), the correlation between three-dimensional dynamic oxygen-enhanced magnetic resonance imaging (OE-MRI) measurements and computed tomography Brody score (CF-CT) and lung function testing (LFT).

Methods

Twenty-one patients (median age, 25 years; female, n = 8) with a range of CF lung disease and five healthy volunteers (median age, 31 years; female, n = 2) underwent OE-MRI performed on a 1.5-T MRI scanner. Coronal volumes were acquired while patients alternately breathed room air and 100% oxygen. Pre-oxygen T1 was measured. Dynamic series of T1-weighted volumes were then obtained while breathing oxygen. T1-parameter maps were generated and the following OE-MRI parameters were measured: oxygen uptake (ΔPO2max), wash-in time and wash-out time. High-resolution CT and LFT were performed. The relationship between CF-CT, LFT and OE-MRI parameters were evaluated using Pearson correlation for the whole lung and regionally.

Results

Mean CF-CT was 24.1±17.1. Mean ΔPO2max and mean wash-in as well as skewness of wash-out showed significant correlation with CF-CT (ΔPO2max: r = -0.741, p < 0.001; mean wash-in: r = 0.501, p = 0.017; skewness of wash-out: r = 0.597, p = 0.001). There was significant correlation for the whole lung and regionally between LFT parameters and OE-MR (ΔPO2max: r = 0.718, p < 0.001; wash-in: r = -0.576, p = 0.003; wash-out skewness: r = -0.552, p = 0.004).

Conclusions

Functional lung imaging using OE-MRI has the capability to assess the severity of CF lung disease and shows a significant correlation with LFT and CF-CT.

Key points

• Oxygen-enhanced MRI might play a future role in evaluation and follow-up of cystic fibrosis.

• Heterogeneity of parameter maps reflects localised functional impairment in cystic fibrosis.

• Avoidance of cumulative radiation burden in CF is feasible using OE-MRI.

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Change history

  • 12 June 2018

    The original version of this article, published on 13 April 2018, unfortunately contained a mistake.

Abbreviations

ΔPO2max :

Delta partial pressure of oxygen in parenchyma

AT-CT:

Subscore for air trapping

BR-CT:

Subscore for bronchial changes

CF:

Cystic fibrosis

CF-CT:

Computed tomography Brody score

ECFS:

CT Standards of Care of the European CF Society

FEV1 :

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

HRCT:

High-resolution computed tomography

LFT:

Lung function test

MMEF:

Maximum mid-expiratory flow

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Acknowledgements

Support and the provision of research features from Philips Clinical Science is gratefully acknowledged.

Funding

This study has received funding by the Swiss Lung association (Lungenliga Schweiz).

Author information

Authors and Affiliations

  1. Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    K. Martini & T. Frauenfelder

  2. University of Zurich, Zurich, Switzerland

    K. Martini, C. M. Gygax & T. Frauenfelder

  3. Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland

    C. Benden

  4. Bioxydyn Limited, Manchester, UK

    A. R. Morgan & G. J. M. Parker

  5. Centre for Imaging Science, The University of Manchester, Manchester, UK

    A. R. Morgan & G. J. M. Parker

Authors
  1. K. Martini
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  2. C. M. Gygax
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  3. C. Benden
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  4. A. R. Morgan
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  5. G. J. M. Parker
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  6. T. Frauenfelder
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Corresponding author

Correspondence to K. Martini.

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Guarantor

The scientific guarantor of this publication is Prof. Thomas Frauenfelder.

Conflict of interest

The authors Dr. Martini, Ms. Gygax, Dr. Benden and Dr. Frauenfelder declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

The authors of this manuscript declare relationships with the following companies: Dr. Morgan reports personal fees from Bioxydyn Ltd, during the conduct of the study; personal fees from GSK, outside the submitted work.

Dr. Parker reports personal fees from Bioxydyn Ltd, during the conduct of the study. In addition, Dr. Parker has a patent PCT/GB2008/001390 issued, and a patent PCT/GB2010/001989 issued.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• diagnostic or prognostic study

• performed at one institution

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Martini, K., Gygax, C.M., Benden, C. et al. Volumetric dynamic oxygen-enhanced MRI (OE-MRI): comparison with CT Brody score and lung function in cystic fibrosis patients. Eur Radiol 28, 4037–4047 (2018). https://doi.org/10.1007/s00330-018-5383-5

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  • DOI: https://doi.org/10.1007/s00330-018-5383-5

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