Dynamic contrast enhanced MRI for the evaluation of lung perfusion in idiopathic pulmonary fibrosis

Luis A Torres; Kristine E Lee; Gregory P Barton; Andrew D Hahn; Nathan Sandbo; Mark L Schiebler; Sean B Fain

doi:10.1183/13993003.02058-2021

Dynamic contrast enhanced MRI for the evaluation of lung perfusion in idiopathic pulmonary fibrosis

Eur Respir J. 2022 Oct 13;60(4):2102058. doi: 10.1183/13993003.02058-2021. Print 2022 Oct.

Authors

Luis A Torres¹, Kristine E Lee², Gregory P Barton¹, Andrew D Hahn¹, Nathan Sandbo³, Mark L Schiebler^{3

4}, Sean B Fain^{5

4

6

7}

Affiliations

¹ Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.
² Dept of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.
³ Dept of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.
⁴ Dept of Radiology, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.
⁵ Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA sean-fain@uiowa.edu.
⁶ Dept of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, USA.
⁷ Dept of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.

Abstract

Background: The objective of this work was to apply quantitative and semiquantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) methods to evaluate lung perfusion in idiopathic pulmonary fibrosis (IPF).

Methods: In this prospective trial 41 subjects, including healthy control and IPF subjects, were studied using DCE-MRI at baseline. IPF subjects were then followed for 1 year; progressive IPF (IPF_prog) subjects were distinguished from stable IPF (IPF_stable) subjects based on a decline in percent predicted forced vital capacity (FVC % pred) or diffusing capacity of the lung for carbon monoxide (D _LCO % pred) measured during follow-up visits. 35 out of 41 subjects were retained for final baseline analysis (control: n=15; IPF_stable: n=14; IPF_prog: n=6). Seven measures and their coefficients of variation (CV) were derived using temporally resolved DCE-MRI. Two sets of global and regional comparisons were made: control versus IPF groups and control versus IPF_stable versus IPF_prog groups, using linear regression analysis. Each measure was compared with FVC % pred, D _LCO % pred and the lung clearance index (LCI % pred) using a Spearman rank correlation.

Results: DCE-MRI identified regional perfusion differences between control and IPF subjects using first moment transit time (FMTT), contrast uptake slope and pulmonary blood flow (PBF) (p≤0.05), while global averages did not. FMTT was shorter for IPF_prog compared with both IPF_stable (p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV and D _LCO % pred (r_s= -0.48, p=0.022) and LCI % pred (r_s= +0.47, p=0.015). Significant group differences were detected in age (p<0.001), D _LCO % pred (p<0.001), FVC % pred (p=0.001) and LCI % pred (p=0.007).

Conclusions: Global analysis obscures regional changes in pulmonary haemodynamics in IPF using DCE-MRI in IPF. Decreased FMTT may be a candidate marker for IPF progression.

Publication types

Clinical Trial
Research Support, N.I.H., Extramural

MeSH terms

Carbon Monoxide
Humans
Idiopathic Pulmonary Fibrosis* / diagnostic imaging
Lung / diagnostic imaging
Magnetic Resonance Imaging / methods
Perfusion
Prospective Studies
Vital Capacity

Substances

Carbon Monoxide

Abstract

Publication types

MeSH terms

Substances

Grants and funding