Science and Research

Delayed contrast dynamics as marker of regional impairment in pulmonary fibrosis using 5D MRI - a pilot study

OBJECTIVE: To analyse delayed contrast dynamics of fibrotic lesions in interstitial lung disease (ILD) using five dimensional (5D) MRI and to correlate contrast dynamics with disease severity. METHODS: 20 patients (mean age: 71 years; M:F, 13:7), with chronic fibrosing ILD: n = 12 idiopathic pulmonary fibrosis (IPF) and n = 8 non-IPF, underwent thin-section multislice CT as part of the standard diagnostic workup and additionally MRI of the lung. 2 min after contrast injection, a radial gradient echo sequence with golden-angle spacing was acquired during 5 min of free-breathing, followed by 5D image reconstruction. Disease was categorized as severe or non-severe according to CT morphological regional severity. For each patient, 10 lesions were analysed. RESULTS: IPF lesions showed later peak enhancement compared to non-IPF (severe: p = 0.01, non-severe: p = 0.003). Severe lesions showed later peak enhancement compared to non-severe lesions, in non-IPF (p = 0.04), but not in IPF (p = 0.35). There was a tendency towards higher accumulation and washout rates in IPF compared to non-IPF in non-severe disease. Severe lesions had lower washout rate than non-severe ones in both IPF (p = 0.003) and non-IPF (p = 0.005). Continuous contrast agent accumulation, without washout, was found only in IPF lesions. CONCLUSIONS: Contrast agent dynamics are influenced by type and severity of pulmonary fibrosis, which might enable a more thorough characterisation of disease burden. The regional impairment is of particular interest in the context of antifibrotic treatments and was characterised using a non-invasive, non-irradiating, free-breathing method. ADVANCES IN KNOWLEDGE: Delayed contrast enhancement patterns allow the assessment of regional lung impairment which could represent different disease stages or phenotypes in ILD.

  • Buzan, M. T.
  • Wetscherek, A.
  • Rank, C. M.
  • Kreuter, M.
  • Heussel, C. P.
  • Kachelriess, M.
  • Dinkel, J.

Keywords

  • Aged
  • Connective Tissue Diseases
  • Contrast Media/*pharmacokinetics
  • Female
  • Humans
  • Idiopathic Interstitial Pneumonias/diagnostic imaging/metabolism/pathology
  • Idiopathic Pulmonary Fibrosis/diagnostic imaging/metabolism/pathology
  • Image Processing, Computer-Assisted/methods
  • Lung Diseases, Interstitial/*diagnostic imaging/metabolism/pathology
  • Magnetic Resonance Imaging/*methods
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Organometallic Compounds/*pharmacokinetics
  • Pilot Projects
  • Principal Component Analysis
  • Prospective Studies
  • Pulmonary Fibrosis/*diagnostic imaging/metabolism/pathology
  • Respiration
  • Severity of Illness Index
  • Time Factors
  • Vital Capacity
Publication details
DOI: 10.1259/bjr.20190121
Journal: Br J Radiol
Pages: 20190121 
Number: 1113
Work Type: Original
Location: CPC-M, TLRC
Disease Area: DPLD, PLI
Partner / Member: DKFZ, KUM, Thorax
Access-Number: 32584606
See publication on PubMed

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