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. 2020 Jun:69:16-21.
doi: 10.1016/j.mri.2020.02.014. Epub 2020 Feb 29.

Free-breathing dynamic contrast-enhanced magnetic resonance of interstitial lung fibrosis

Nathan E Frenk  1 , Sydney B Montesi  2 , Tianqi Chen  3 , Lloyd L Liang  2 , Iris Zhou  4 , Ravi Seethamraju  5 , Peter Caravan  6 , Subba R Digumarthy  7
Affiliations

Free-breathing dynamic contrast-enhanced magnetic resonance of interstitial lung fibrosis

Nathan E Frenk et al. Magn Reson Imaging. 2020 Jun.

Abstract

Purpose: Computed tomography (CT) imaging is the standard to assess interstitial lung disease. Magnetic resonance (MR) is potentially advantageous due to superior tissue characterization and better assessment of blood flow dynamics. This study aimed to evaluate idiopathic pulmonary fibrosis (IPF) using prototype 4D Stack of Stars GRE (StarVIBE) MR and compare it to CT.

Method: This IRB-approved prospective study included 13 patients [5F:8M; average age 66 ± 8.1 years] with pulmonary fibrosis, and 12 healthy controls [3F:9M; average age 55 ± 3.6 years]. MR of the chest included noncontrast steady-state free precession imaging (SSFP) and free-breathing 4D StarVIBE sequence with intravenous contrast administration up to 160 s. The images were assessed for quality and artifacts. The image resolution was evaluated based on the visibility of the smallest bronchi, vessels, lymph nodes, and pleural fissures. Independent assessment of reticulation, ground-glass opacity, and traction bronchiectasis was performed and compared to CT.

Results: The StarVIBE images had fewer artifacts and higher spatial resolution. The findings associated with IPF were significantly better seen with StarVIBE, with superior CT correlation.

Conclusion: Contrast-enhanced free-breathing StarVIBE MR can generate high quality images with good correlation to CT in patients with IPF, and with high spatial and temporal resolution to generate rapid sequential dynamic images.

Keywords: Interstitial lung disease; Magnetic resonance imaging; Pulmonary fibrosis; StarVIBE.

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Conflict of interest statement

Declaration of competing interest R.S. is an employee of Siemens Healthcare. The other authors report no potential conflicts of interest.

Figures

Figure 1.
Figure 1.
73-year-old female with idiopathic pulmonary fibrosis. Axial noncontrast CT (A) demonstrates bilateral subpleural ground-glass opacities and reticulation, right upper lobe honeycombing (black arrow) and left upper lobe traction bronchiolectasis (white arrow). Both axial steady-state free precession imaging (SSFP) (B) and 160-s post-contrast StarVIBE (C) images from MRI performed 2 months after the CT demonstrate similar findings. Note also how findings are much more evident on StarVIBE than on SSFP images, and improved conspicuity of the left major fissure (which is only barely visible on SSFP). Also note the pulsation artifacts along the aortic arch in the SSFP image.
Figure 2.
Figure 2.
60-year-old female with familial idiopathic pulmonary fibrosis. Coronal reformat contrast-enhanced CT image (A) demonstrates bilateral left greater than right subpleural reticulation and ground-glass opacity, right apical honeycombing (black arrow), and left basilar traction bronchiectasis (white arrow). Coronal StarVIBE images before (B) and at 53 s (C), 105 s (D) and 160 s (E) after contrast administration demonstrate increased conspicuity of findings in delayed images, particularly of traction bronchiectasis (most of which cannot be confidently appreciated before contrast administration).
See this image and copyright information in PMC

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