Acute COPD exacerbation: 3 T MRI evaluation of pulmonary regional perfusion – Preliminary experience

Sergiacomi, Gianluigi; Taglieri, Amedeo; Chiaravalloti, Antonio; Calabria, Eros; Arduini, Silvia; Tosti, Daniela; Citraro, Daniele; Pezzuto, Gabriella; Puxeddu, Ermanno; Simonetti, Giovanni

doi:10.1016/j.rmed.2014.04.002

Cited by 9 publications

(12 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In general, most studies discussed imaging biomarkers either as prevalence values of radiological findings in a population of subjects with an exacerbation of COPD, or as quantitative measurements of an imaging feature. A total of 10 of the 51 papers [9][10][11][12][13][14][15][16][17][18] presented quantitative measurements of imaging features at exacerbation. One paper presented quantitative individual patient data, but no cohort averages, 19 and the remaining 40 papers presented prevalence values for established radiological or other features.…”

Section: Search Resultsmentioning

confidence: 99%

<p>Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review</p>

Rangelov

Young

Jacob

et al. 2020

COPD

View full text Add to dashboard Cite

Exacerbations of chronic obstructive pulmonary disease (COPD) are currently diagnosed based on changes in respiratory symptoms. Characterizing the imaging manifestation of exacerbations could be useful for objective diagnosis of exacerbations in the clinic and clinical trials, as well as provide a mechanism for monitoring exacerbation treatment and recovery. In this systematic review, we employed a comprehensive search across three databases (Medline, EMBASE, Web of Science) to identify studies that performed imaging of the thorax at COPD exacerbation. We included 51 from a total of 5,047 articles which met all our inclusion criteria. We used an adapted version of the Modified Newcastle-Ottawa Quality Assessment Scale for cohort studies to assess the quality of the included studies. Conclusions were weighted towards higher-quality articles. We identified a total of 36 thoracic imaging features studied at exacerbation of COPD. Studies were generally heterogeneous in their measurements and focus. Nevertheless, considering studies which performed consecutive imaging at stable state and exacerbation, which scored highest for quality, we identified salient imaging biomarkers of exacerbations. An exacerbation is characterized by airway wall and airway calibre changes, hyperinflation, pulmonary vasoconstriction and imaging features suggestive of pulmonary arterial hypertension. Most information was gained from CT studies. We present the first ever composite imaging signature of COPD exacerbations. While imaging during an exacerbation is comparatively new and not comprehensively studied, it may uncover important insights into the acute pathophysiologic changes in the cardiorespiratory system during exacerbations of COPD, providing objective confirmation of events and a biomarker of recovery and treatment response.

show abstract

Section: Search Resultsmentioning

confidence: 99%

<p>Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review</p>

Rangelov

Young

Jacob

et al. 2020

COPD

View full text Add to dashboard Cite

show abstract

“…Dynamic gadolinium/contrast material‐enhanced (DCE) magnetic resonance imaging (MRI) is an established technique to quantify PBF in lung diseases like COPD and cystic fibrosis. Impairment of PBF could be observed even in mild COPD, and thus might be an early marker for disease detection and monitoring . However, DCE MRI requires the administration of gadolinium‐based intravenous contrast agents, which have been reported to cause nephrogenic systemic sclerosis in patients with renal failure and gadolinium deposition in the brain as well as other parts of the body independent of renal function .…”

mentioning

confidence: 99%

Comparison of quantitative regional perfusion‐weighted phase resolved functional lung (PREFUL) MRI with dynamic gadolinium‐enhanced regional pulmonary perfusion MRI in COPD patients

Kaireit

Voskrebenzev

Gutberlet

et al. 2018

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background: Perfusion-weighted noncontrast-enhanced proton lung MRI during free breathing is maturing as a novel technique for assessment of regional lung perfusion, but has not yet been validated in chronic obstructive pulmonary disease (COPD) patients. Purpose: To compare pulmonary parenchymal perfusion assessed by noncontrast-enhanced perfusion-weighted phaseresolved functional lung (PREFUL)-MRI with lung perfusion determined with dynamic gadolinium-enhanced (DCE)-MRI and with lung function test parameters. Study Type: Prospective. Population: A single-center subset of the COPD cohort "COPD and SYstemic consequenzes-COmorbidities NETwork" (COSYCONET). Forty-seven patients with COPD (median age 66 [57-70] years) were studied. Field Strength/Sequence: For PREFUL-MRI a spoiled gradient echo sequence and for DCE-MRI, a 3D time-resolved spoiled gradient echo sequence was used at 1.5T. Assessment: PREFUL-MRI coronal slices were acquired in free breathing. DCE-MRI was performed in breath-hold with administration of 0.025 mmol/kg bodyweight of gadobutrol i.v. at a rate of 4 ml/s and pulmonary blood flow (PBF) maps were calculated. Slices of PREFUL and DCE-MRI were matched by their ventrodorsal position and corresponding slices were coregistered for evaluation. Perfusion defect percentages (QDP) were calculated for both methods. Statistical Tests: The obtained parameters were correlated using Spearman's correlation coefficient (r) and Bland-Altman plot analysis. Results: PREFUL-QDP showed an absolute and spatial agreement with PBF-QDP on a global (39.3 (31.8-45.5)% vs. 44.7 (35.4-50.0)% with a spatial overlap of 62.2 (57.2-67.2)%)) as well as on a lobar level and correlated with lung function test parameters (PREFUL-QDP vs. FEV 1 , r = -0.75, P < 0.0001). There was a systematic overestimation of PREFUL-QDP compared with PBF-QDP, mainly in the lower lobes, resulting in an overall overestimation for the whole lung with a mean difference of 5% (95% confidence interval [CI]: 3.0%; 7.0%; STD 6.8%). Data Conclusion: PREFUL-MRI is a promising noninvasive, radiation-free tool for quantification of regional perfusion in COPD patients. Level of Evidence: 1 Technical Efficacy: Stage 2

show abstract

“…DCE perfusion scores have been shown to correlate with markers of COPD severity: a reduction in PBF and PBV is associated with worsening CT emphysema score, airflow limitation and DLCO (50,51). Furthermore, exacerbations of COPD are associated with a prolonged MTT and TTP (52).…”

Section: Clinical Applications Of Pulmonary Mra and Perfusion Imagingmentioning

confidence: 99%

Pulmonary MR angiography and perfusion imaging—A review of methods and applications

Johns

Swift

Hughes

et al. 2017

European Journal of Radiology

View full text Add to dashboard Cite

Acute COPD exacerbation: 3 T MRI evaluation of pulmonary regional perfusion – Preliminary experience

Cited by 9 publications

References 33 publications

<p>Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review</p>

<p>Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review</p>

Comparison of quantitative regional perfusion‐weighted phase resolved functional lung (PREFUL) MRI with dynamic gadolinium‐enhanced regional pulmonary perfusion MRI in COPD patients

Pulmonary MR angiography and perfusion imaging—A review of methods and applications

Contact Info

Product

Resources

About