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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
European Respiratory Journal 2022 60: 2102058; DOI: 10.1183/13993003.02058-2021
Luis A. Torres
1Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
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  • ORCID record for Luis A. Torres
Kristine E. Lee
2Dept of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
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Gregory P. Barton
1Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
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Andrew D. Hahn
1Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
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Nathan Sandbo
3Dept of Medicine, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
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Mark L. Schiebler
3Dept of Medicine, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
4Dept of Radiology, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
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Sean B. Fain
1Dept of Medical Physics, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
4Dept of Radiology, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, WI, USA
5Dept of Biomedical Engineering, College of Engineering, University of Wisconsin – Madison, Madison, WI, USA
6Dept of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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  • For correspondence: sean-fain@uiowa.edu
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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 (IPFprog) subjects were distinguished from stable IPF (IPFstable) subjects based on a decline in percent predicted forced vital capacity (FVC % pred) or diffusing capacity of the lung for carbon monoxide (DLCO % pred) measured during follow-up visits. 35 out of 41 subjects were retained for final baseline analysis (control: n=15; IPFstable: n=14; IPFprog: 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 IPFstable versus IPFprog groups, using linear regression analysis. Each measure was compared with FVC % pred, DLCO % 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 IPFprog compared with both IPFstable (p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV and DLCO % pred (rs= −0.48, p=0.022) and LCI % pred (rs= +0.47, p=0.015). Significant group differences were detected in age (p<0.001), DLCO % 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.

Abstract

DCE-MRI quantitative perfusion and semiquantitative transit time metrics identified regional deficits in IPF lung disease relative to healthy control subjects and in IPF progression https://bit.ly/3swKH6r

Footnotes

  • Conflict of interest: M.L. Schiebler reports grant funding from the National Heart, Lung, and Blood Institute (NHLBI SARPIII RFA-HL-11-018 and SARP IV 4P01 HL088594-09, R01 HL080414) and ownership of Elucida Oncology Inc., Elucida Medical Inc., Healthmyne Inc., Stemina Biomarker Discovery Inc. and X-Vax Inc. S.B. Fain reports grant funding from the NHLBI (R01 HL126771, R01 HL146689), GE Healthcare, American Lung Association, as well as compensation from Caladarius Biosciences, Polarean PLC and Sanofi/Regeneron. All other authors have nothing to disclose.

  • Support statement: This work was funded by the National Heart, Lung, and Blood Institute (R01 HL126771, R01 HL136965) and the National Center for Research Resources (S10 OD016394). Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received July 24, 2021.
  • Accepted February 24, 2022.
  • Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
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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
European Respiratory Journal Oct 2022, 60 (4) 2102058; DOI: 10.1183/13993003.02058-2021

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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
European Respiratory Journal Oct 2022, 60 (4) 2102058; DOI: 10.1183/13993003.02058-2021
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