Repeatability of Phase-Resolved Functional Lung (PREFUL)-MRI Ventilation and Perfusion Parameters in Healthy Subjects and COPD Patients

Gesa H Pöhler; Filip Klimeš; Lea Behrendt; Andreas Voskrebenzev; Cristian Crisosto Gonzalez; Frank Wacker; Jens M Hohlfeld; Jens Vogel-Claussen

doi:10.1002/jmri.27385

Repeatability of Phase-Resolved Functional Lung (PREFUL)-MRI Ventilation and Perfusion Parameters in Healthy Subjects and COPD Patients

J Magn Reson Imaging. 2021 Mar;53(3):915-927. doi: 10.1002/jmri.27385. Epub 2020 Oct 14.

Authors

Gesa H Pöhler^{1

2}, Filip Klimeš^{1

2}, Lea Behrendt^{1

2}, Andreas Voskrebenzev^{1

2}, Cristian Crisosto Gonzalez^{1

2}, Frank Wacker^{1

2}, Jens M Hohlfeld^{2

3

4}, Jens Vogel-Claussen^{1

2}

Affiliations

¹ Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
² Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.
³ Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.
⁴ Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany.

PMID: 33058351
DOI: 10.1002/jmri.27385

Abstract

Background: Free-breathing phase-resolved functional lung (PREFUL)-MRI may be useful for treatment monitoring in chronic obstructive pulmonary disease (COPD) patients with dyspnea. PREFUL test-retest reliability is essential for clinical application.

Purpose: To measure the repeatability of PREFUL-MRI ventilation (V) and perfusion (Q) parameters.

Study type: Retrospective and prospective.

Population: A total of 28 COPD patients and 57 healthy subjects.

Field strength/sequence: 1.5T MRI/2D spoiled gradient echo imaging.

Assessment: V and Q lung parameter maps based on three coronal slices were obtained at baseline and after 14 days (COPD patients) or after a short pause outside the scanner (healthy subjects). Regional ventilation (RVent) and imaging flow volume loops by cross-correlation (ccVent) were quantified. Q was normalized to the signal of the main pulmonary artery (Q_N ) and quantified (Q_Quant ). Pulmonary pulse wave transit time (pPTT), voxel-by-voxel (regional), and whole lung (global) ventilation defect percentage based on RVent (VDP_RVent ) and ccVent (VDP_ccVent ), perfusion defect percentage (QDP), and ventilation/perfusion match based on RVent (VQM_RVent ) and ccVent (VQM_ccVent ) were calculated.

Statistical tests: Regional V and Q were analyzed globally for each subject. Each parameter's median of scans 1 and 2 were assessed by Wilcoxon sign rank test. A parameter's repeatability was analyzed by Bland-Altman analyses, coefficients of variation, intraclass correlation coefficients (ICC), and power calculations. The regional voxel repeatability was examined by calculating the Sørensen-Dice coefficient.

Results: There was no bias and no significant differences between the first and second MRI for any parameters (P > 0.05). Coefficient of variation ranged from 2.26% (ccVent) to 19.31% (QDP), ICC from 0.93 (QDP) to 0.60 (pPTT), the smallest detectable difference was 0.002 ccVent. Regional comparison showed the highest overlap (84%) in VDP_RVent in healthy voxels and the lowest (53%) in VDP_ccVent defect voxels.

Data conclusion: V and Q PREFUL-MRI parameters were repeatable over two scan sessions in both healthy controls and COPD patients.

Level of evidence: 2 TECHNICAL EFFICACY STAGE: 2.

Keywords: biomarker; functional lung MRI; perfusion; repeatability; ventilation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Healthy Volunteers
Humans
Lung* / diagnostic imaging
Magnetic Resonance Imaging
Perfusion
Prospective Studies
Pulmonary Disease, Chronic Obstructive* / diagnostic imaging
Reproducibility of Results
Retrospective Studies