Comparison of Free-Breathing 3D Phase-Resolved Functional Lung (PREFUL) MRI With Dynamic 19 F Ventilation MRI in Patients With Obstructive Lung Disease and Healthy Volunteers

Filip Klimeš; Arnd J Obert; Julienne Scheller; Marius M Wernz; Andreas Voskrebenzev; Marcel Gutberlet; Robert Grimm; Hendrik Suhling; Robin A Müller; Till F Kaireit; Julian Glandorf; Tawfik Moher Alsady; Frank Wacker; Jens Vogel-Claussen

doi:10.1002/jmri.29221

Comparison of Free-Breathing 3D Phase-Resolved Functional Lung (PREFUL) MRI With Dynamic ¹⁹ F Ventilation MRI in Patients With Obstructive Lung Disease and Healthy Volunteers

J Magn Reson Imaging. 2024 Jan 12. doi: 10.1002/jmri.29221. Online ahead of print.

Authors

Filip Klimeš^{1

2}, Arnd J Obert³, Julienne Scheller^{1

2}, Marius M Wernz^{1

2}, Andreas Voskrebenzev^{1

2}, Marcel Gutberlet^{1

2}, Robert Grimm⁴, Hendrik Suhling^{2

5}, Robin A Müller^{1

2}, Till F Kaireit^{1

2}, Julian Glandorf^{1

2}, Tawfik Moher Alsady^{1

2}, Frank Wacker^{1

2}, Jens Vogel-Claussen^{1

2}

Affiliations

¹ Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.
² Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany.
³ Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany.
⁴ MR Application Predevelopment, Siemens Healthineers AG, Erlangen, Germany.
⁵ Department of Respiratory Medicine, Hannover Medical School, Hanover, Germany.

PMID: 38214459
DOI: 10.1002/jmri.29221

Abstract

Background: Non-contrast-enhanced ¹ H magnetic resonance imaging (MRI) with full lung coverage shows promise for assessment of regional lung ventilation but a comparison with direct ventilation measurement using ¹⁹ F MRI is lacking.

Purpose: To compare ventilation parameters calculated using 3D phase-resolved functional lung (PREFUL) MRI with ¹⁹ F MRI.

Study type: Prospective.

Population: Fifteen patients with asthma, 14 patients with chronic obstructive lung disease, and 13 healthy volunteers.

Field strength/sequence: A 3D gradient-echo pulse sequence with golden-angle increment and stack-of-stars encoding at 1.5 T.

Assessment: All participants underwent 3D PREFUL MRI and ¹⁹ F MRI. For 3D PREFUL, static regional ventilation (RVent) and dynamic flow-volume cross-correlation metric (FVL-CM) were calculated. For both parameters, ventilation defect percentage (VDP) values and ventilation defect (VD) maps (including a combination of both parameters [VDP_Combined ]) were determined. For ¹⁹ F MRI, images from eight consecutive breaths under volume-controlled inhalation of perfluoropropane were acquired. Time-to-fill (TTF) and wash-in (WI) parameters were extracted. For all ¹⁹ F parameters, a VD map was generated and the corresponding VDP values were calculated.

Statistical tests: For all parameters, the relationship between the two techniques was assessed using a Spearman correlation (r). Differences between VDP values were compared using Bland-Altman analysis. For regional comparison of VD maps, spatial overlap and Sørensen-Dice coefficients were computed.

Results: 3D PREFUL VDP values were significantly correlated to VDP measures by ¹⁹ F (r range: 0.59-0.70). For VDP_RVent , no significant bias was observed with VDP of the third and fourth breath (bias range = -6.8:7.7%, P range = 0.25:0.30). For VDP_FVL-CM , no significant bias was found with VDP values of fourth-eighth breaths (bias range = -2.0:12.5%, P range = 0.12:0.75). The overall spatial overlap of all VD maps increased with each breath, ranging from 61% to 81%, stabilizing at the fourth breath.

Data conclusion: 3D PREFUL MRI parameters showed moderate to strong correlation with ¹⁹ F MRI. Depending on the 3D PREFUL VD map, the best regional agreement was found to ¹⁹ F VD maps of third-fifth breath.

Level of evidence: 3 TECHNICAL EFFICACY: Stage 2.

Keywords: COPD; asthma; lung; ventilation.

Grants and funding

German Center for Lung Research