Phenotyping of COPD with MRI in comparison to same-day CT in a multi-centre trial

Objectives: A prospective, multi-centre study to evaluate concordance of morphologic lung MRI and CT in chronic obstructive pulmonary disease (COPD) phenotyping for airway disease and emphysema. Methods: A total of 601 participants with COPD from 15 sites underwent same-day morpho-functional chest M...

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Main Authors: Nauck, Sebastian (Author) , Pohl, Moritz (Author) , Jobst, Bertram (Author) , Melzig, Claudius (Author) , Meredig, Hagen (Author) , Weinheimer, Oliver (Author) , Triphan, Simon M. F. (Author) , Stackelberg, Oyunbileg von (Author) , Konietzke, Philip (Author) , Kauczor, Hans-Ulrich (Author) , Heußel, Claus Peter (Author) , Wielpütz, Mark Oliver (Author) , Biederer, Jürgen (Author)
Format: Article (Journal)
Language:English
Published: 12 February 2024
In: European radiology
Year: 2024, Volume: 34, Issue: 9, Pages: 5597-5609
ISSN:1432-1084
DOI:10.1007/s00330-024-10610-0
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s00330-024-10610-0
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Author Notes:Sebastian Nauck, Moritz Pohl, Bertram J. Jobst, Claudius Melzig, Hagen Meredig, Oliver Weinheimer, Simon Triphan, Oyunbileg von Stackelberg, Philip Konietzke, Hans-Ulrich Kauczor, Claus P. Heußel, Mark O. Wielpütz, Jürgen Biederer and on behalf of the COSYCONET Study Group

MARC

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520 |a Objectives: A prospective, multi-centre study to evaluate concordance of morphologic lung MRI and CT in chronic obstructive pulmonary disease (COPD) phenotyping for airway disease and emphysema. Methods: A total of 601 participants with COPD from 15 sites underwent same-day morpho-functional chest MRI and paired inspiratory-expiratory CT. Two readers systematically scored bronchial wall thickening, bronchiectasis, centrilobular nodules, air trapping and lung parenchyma defects in each lung lobe and determined COPD phenotype. A third reader acted as adjudicator to establish consensus. Inter-modality and inter-reader agreement were assessed using Cohen’s kappa (im-κ and ir-κ). Results: The mean combined MRI score for bronchiectasis/bronchial wall thickening was 4.5/12 (CT scores, 2.2/12 for bronchiectasis and 6/12 for bronchial wall thickening; im-κ, 0.04–0.3). Expiratory right/left bronchial collapse was observed in 51 and 47/583 on MRI (62 and 57/599 on CT; im-κ, 0.49–0.52). Markers of small airways disease on MRI were 0.15/12 for centrilobular nodules (CT, 0.34/12), 0.94/12 for air trapping (CT, 0.9/12) and 7.6/12 for perfusion deficits (CT, 0.37/12 for mosaic attenuation; im-κ, 0.1–0.41). The mean lung defect score on MRI was 1.3/12 (CT emphysema score, 5.8/24; im-κ, 0.18–0.26). Airway-/emphysema/mixed COPD phenotypes were assigned in 370, 218 and 10 of 583 cases on MRI (347, 218 and 34 of 599 cases on CT; im-κ, 0.63). For all examined features, inter-reader agreement on MRI was lower than on CT. Conclusion: Concordance of MRI and CT for phenotyping of COPD in a multi-centre setting was substantial with variable inter-modality and inter-reader concordance for single diagnostic key features. Clinical relevance statement: MRI of lung morphology may well serve as a radiation-free imaging modality for COPD in scientific and clinical settings, given that its potential and limitations as shown here are carefully considered. 
650 4 |a Chronic obstructive pulmonary disease 
650 4 |a Computed tomography 
650 4 |a Magnetic resonance imaging 
650 4 |a Pulmonary emphysema 
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