Pulmonary fibrosis: tissue characterization using late-enhanced MRI compared with unenhanced anatomic high-resolution CT

Lavelle, Lisa P.; Brady, Darragh; McEvoy, Sinéad H.; Murphy, David J.; Gibney, Brian; Gallagher, Annika; Butler, Marcus W.; Shortt, F.; McMullen, Marie; Fabre, Aurélie; Lynch, David A.; Keane, Michael P.; Dodd, Jonathan D.

doi:10.5152/dir.2016.15331

Cited by 29 publications

(24 citation statements)

References 28 publications

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“…These results are in line with previous reports of stronger links between FVC decline and mortality in baseline upper/middle zone VRS when compared to lower zone VRS in patients with IPF . MRI studies have demonstrated that fibrotic tissues show delayed contrast enhancement when compared to morphologically normal appearing lung in lung fibrosis patients . A local increase in pulmonary vascular resistance in fibrotic areas may reduce regional pulmonary blood flow due to both hypoxic vasoconstriction and proliferative remodelling caused by inflammation.…”

Section: Discussionsupporting

confidence: 92%

Quantitative CT‐derived vessel metrics in idiopathic pulmonary fibrosis: A structure–function study

et al. 2019

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Background and objective This study aimed to investigate whether quantitative lung vessel morphology determined by a new fully automated algorithm is associated with functional indices in idiopathic pulmonary fibrosis (IPF). Methods A total of 152 IPF patients had vessel volume, density, tortuosity and heterogeneity quantified from computed tomography (CT) images by a fully automated algorithm. Separate quantitation of vessel metrics in pulmonary arteries and veins was performed in 106 patients. Results were evaluated against readouts from lung function tests. Results Normalized vessel volume expressed as a percentage of total lung volume was moderately correlated with functional indices on univariable linear regression analysis: forced vital capacity (R2 = 0.27, P < 1 × 10−6), diffusion capacity for carbon monoxide (DLCO; R2 = 0.12, P = 3 × 10−5), total lung capacity (TLC; R2 = 0.45, P < 1 × 10−6) and composite physiologic index (CPI; R2 = 0.28, P < 1 × 10−6). Normalized vessel volume was correlated with vessel density but not with vessel heterogeneity. Quantitatively derived vessel metrics (and artery and vein subdivision scores) were not significantly linked with the transfer factor for carbon monoxide (KCO), and only weakly with DLCO. On multivariable linear regression analysis, normalized vessel volume and vessel heterogeneity were independently linked with DLCO, TLC and CPI indicating that they capture different aspects of lung damage. Artery–vein separation provided no additional information beyond that captured in the whole vasculature. Conclusion Our study confirms previous observations of links between vessel volume and functional measures of disease severity in IPF using a new vessel quantitation tool. Additionally, the new tool shows independent linkages of normalized vessel volume and vessel heterogeneity with functional indices. Quantitative vessel metrics do not appear to reflect vasculopathic damage in IPF.

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Section: Discussionsupporting

confidence: 92%

Quantitative CT‐derived vessel metrics in idiopathic pulmonary fibrosis: A structure–function study

et al. 2019

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“…In this study, a specific double inversion-recovery gradient echo-pulse sequence was used to null the pulmonary arterial blood signal and depict pulmonary fibrosis with late-enhanced MRI. LAVELLE et al [46] demonstrated that the extent of pulmonary fibrosis on late-enhanced MRI correlated significantly with thin-slices MDCT (r=0.78, p<0.001). However, the percentage of reticulation or honeycombing showed no significant correlations between the two modalities ( p=0.34 and p=0.23, respectively).…”

Section: Contrast-enhanced Techniquesmentioning

confidence: 98%

“…As matter of fact, gadolinium-based contrast agent (GBCA) washes out from normal tissue while it remains in fibrotic tissue. This characteristic was used by LAVELLE et al [46] to detect and characterise pulmonary fibrosis. In this study, a specific double inversion-recovery gradient echo-pulse sequence was used to null the pulmonary arterial blood signal and depict pulmonary fibrosis with late-enhanced MRI.…”

Section: Contrast-enhanced Techniquesmentioning

confidence: 99%

The use of chest magnetic resonance imaging in interstitial lung disease: a systematic review

et al. 2018

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@ERSpublications Although MRI resolution does not yet match that of CT, MRI can play an important role for functional imaging in patients with ILD. MRI can differentiate between inflammatory and fibrotic changes for monitoring targeted therapy in patients with ILD.ABSTRACT Thin-slices multi-detector computed tomography (MDCT) plays a key role in the differential diagnosis of interstitial lung disease (ILD). However, thin-slices MDCT has a limited ability to detect active inflammation, which is an important target of newly developed ILD drug therapy. Magnetic resonance imaging (MRI), thanks to its multi-parameter capability, provides better tissue characterisation than thin-slices MDCT.Our aim was to summarise the current status of MRI applications in ILD and to propose an ILD-MRI protocol. A systematic literature search was conducted for relevant studies on chest MRI in patients with ILD.We retrieved 1246 papers of which 55 original papers were selected for the review. We identified 24 studies comparing image quality of thin-slices MDCT and MRI using several MRI sequences. These studies described new MRI sequences to assess ILD parenchymal abnormalities, such as honeycombing, reticulation and ground-glass opacity. Thin-slices MDCT remains superior to MRI for morphological imaging. However, recent studies with ultra-short echo-time MRI showed image quality comparable to thin-slices MDCT. Several studies demonstrated the added value of chest MRI by using functional imaging, especially to detect and quantify inflammatory changes.We concluded that chest MRI could play a role in ILD patients to differentiate inflammatory and fibrotic changes and to assess efficacy of new ILD drugs.

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“…There are a handful of studies investigating various magnetic resonance imaging (MRI) sequences such as spin echo, inversion recovery or dynamic post-contrast T1-weighted multishot turbo field-echo sequences in IPF [83][84][85][86]. The principle for the majority of these studies is based on the assumption that, in contrast to normal lung tissue, fibrotic lung tissue demonstrates significant contrast enhancement on late-enhanced MRI sequences, which is a well-established fact in the assessment of myocardial fibrosis on cardiac MRI.…”

Section: Magnetic Resonance Imaginingmentioning

confidence: 99%

Evaluating disease severity in idiopathic pulmonary fibrosis

et al. 2017

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Accurate assessment of idiopathic pulmonary fibrosis (IPF) disease severity is integral to the care provided to patients with IPF. However, to date, there are no generally accepted or validated staging systems. There is an abundance of data on using information acquired from physiological, radiological and pathological parameters, in isolation or in combination, to assess disease severity in IPF. Recently, there has been interest in using serum biomarkers and computed tomography-derived quantitative lung fibrosis measures to stage disease severity in IPF. This review will focus on the suggested methods for staging IPF, at baseline and on serial assessment, their strengths and limitations, as well as future developments.

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Pulmonary fibrosis: tissue characterization using late-enhanced MRI compared with unenhanced anatomic high-resolution CT

Cited by 29 publications

References 28 publications

Quantitative CT‐derived vessel metrics in idiopathic pulmonary fibrosis: A structure–function study

Quantitative CT‐derived vessel metrics in idiopathic pulmonary fibrosis: A structure–function study

The use of chest magnetic resonance imaging in interstitial lung disease: a systematic review

Evaluating disease severity in idiopathic pulmonary fibrosis

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