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...

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Main Authors: Buzan, Maria Teodora (Author) , Wetscherek, Andreas (Author) , Rank, Christopher M. (Author) , Kreuter, Michael (Author) , Heußel, Claus Peter (Author) , Kachelrieß, Marc (Author) , Dinkel, Julien (Author)
Format: Article (Journal)
Language:English
Published: [2020]
In: British journal of radiology
Year: 2020, Volume: 93, Issue: 1113
ISSN:1748-880X
DOI:10.1259/bjr.20190121
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1259/bjr.20190121
Verlag, lizenzpflichtig, Volltext: https://www.birpublications.org/doi/10.1259/bjr.20190121
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Author Notes:Maria TA Buzan, Andreas Wetscherek, Christopher M Rank, Michael Kreuter, Claus Peter Heussel, Marc Kachelrieß, Julien Dinkel

MARC

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520 |a 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. 
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