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Dynamic Contrast Enhanced MRI for the Evaluation of Lung Perfusion in Idiopathic Pulmonary Fibrosis
Journal article   Peer reviewed

Dynamic Contrast Enhanced MRI for the Evaluation of Lung Perfusion in Idiopathic Pulmonary Fibrosis

Luis A Torres, Kristine E Lee, Gregory P Barton, Andrew D Hahn, Nathan Sandbo, Mark L Schiebler and Sean B Fain
The European respiratory journal, Vol.60(4), 2102058
03/10/2022
DOI: 10.1183/13993003.02058-2021
PMCID: PMC10015995
PMID: 35273033

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Abstract

The objective of this work was to apply quantitative and semi-quantitative dynamic contrast enhanced MRI (DCE-MRI) methods to evaluate lung perfusion in idiopathic pulmonary fibrosis (IPF). In this prospective trial 41 subjects, including healthy control (control) and IPF subjects, were studied using DCE-MRI at baseline. IPF subjects were then followed for 1 year, progressive IPF (IPF ) were distinguished from stable IPF (IPF ) subjects based on a decline in percent predicted FVC (FVC%p) or DLCO (DLCO%p) measured during followup visits. 35/41 subjects were retained for final baseline analysis at (control: N=15; IPF : N=14; IPF : N=6). Seven measures and their coefficients of variation (CV) were derived using temporally resolved DCE-MRI. Two sets of global and regional comparisons were made: control IPF groups, and control IPF IPF groups, using linear regression analysis. Each measure was compared to FVC%p, DLCO%p, and the lung clearance index (LCI%p) using a Spearman rank correlation. DCE-MRI identified regional perfusion differences between control and IPF subjects using first moment transit time (FMTT), contrast uptake slope (SLOPE), and pulmonary blood flow (PBF) (p≤0.05), while global averages did not. FMTT was shorter for IPF compared to both IPF (p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV and DLCO%p (r =-0.48, p=0.022) and %LCI (r =+0.47, p=0.015). Significant group differences were detected in age (p<0.001), DLCO%p (p<0.001), FVC%p (p=0.001), and LCI%p (p=0.007). Global analysis obscures regional changes in pulmonary hemodynamics in IPF using DCE-MRI in IPF. Decreased FMTT may be a candidate marker for IPF progression.

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