1
|
Singh D, Han MK, Hawkins NM, Hurst JR, Kocks JWH, Skolnik N, Stolz D, El Khoury J, Gale CP. Implications of Cardiopulmonary Risk for the Management of COPD: A Narrative Review. Adv Ther 2024; 41:2151-2167. [PMID: 38664329 PMCID: PMC11133105 DOI: 10.1007/s12325-024-02855-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/22/2024] [Indexed: 05/29/2024]
Abstract
Chronic obstructive pulmonary disease (COPD) constitutes a major global health burden and is the third leading cause of death worldwide. A high proportion of patients with COPD have cardiovascular disease, but there is also evidence that COPD is a risk factor for adverse outcomes in cardiovascular disease. Patients with COPD frequently die of respiratory and cardiovascular causes, yet the identification and management of cardiopulmonary risk remain suboptimal owing to limited awareness and clinical intervention. Acute exacerbations punctuate the progression of COPD in many patients, reducing lung function and increasing the risk of subsequent exacerbations and cardiovascular events that may lead to early death. This narrative review defines and summarises the principles of COPD-associated cardiopulmonary risk, and examines respiratory interventions currently available to modify this risk, as well as providing expert opinion on future approaches to addressing cardiopulmonary risk.
Collapse
Affiliation(s)
- Dave Singh
- Medicines Evaluation Unit, Manchester University NHS Foundation Trust, University of Manchester, Manchester, M23 9QZ, UK.
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Janwillem W H Kocks
- General Practitioners Research Institute, Groningen, The Netherlands
- Observational and Pragmatic Research Institute, Singapore, Singapore
- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Daiana Stolz
- Clinic of Respiratory Medicine, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Chris P Gale
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| |
Collapse
|
2
|
Peggs ZJT, Brooke JP, Bolton CE, Hall IP, Francis ST, Gowland PA. Free-Breathing Functional Pulmonary Proton MRI: A Novel Approach Using Voxel-Wise Lung Ventilation (VOLVE) Assessment in Healthy Volunteers and Patients With Chronic Obstructive Pulmonary Disease. J Magn Reson Imaging 2024. [PMID: 38819593 DOI: 10.1002/jmri.29444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/27/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND In respiratory medicine, there is a need for sensitive measures of regional lung function that can be performed using standard imaging technology, without the need for inhaled or intravenous contrast agents. PURPOSE To describe VOxel-wise Lung VEntilation (VOLVE), a new method for quantifying regional lung ventilation (V) and perfusion (Q) using free-breathing proton MRI, and to evaluate VOLVE in healthy never-smokers, healthy people with smoking history, and people with chronic obstructive pulmonary disease (COPD). STUDY TYPE Prospective pilot. POPULATION Twelve healthy never-smoker participants (age 30.3 ± 12.5 years, five male), four healthy participants with smoking history (>10 pack-years) (age 42.5 ± 18.3 years, one male), and 12 participants with COPD (age 62.8 ± 11.1 years, seven male). FIELD STRENGTH/SEQUENCE Single-slice free-breathing two-dimensional fast field echo sequence at 3 T. ASSESSMENT A novel postprocessing was developed to evaluate the MR signal changes in the lung parenchyma using a linear regression-based approach, which makes use of all the data in the time series for maximum sensitivity. V/Q-weighted maps were produced by computing the cross-correlation, lag and gradient between the respiratory/cardiac phase time course and lung parenchyma signal time courses. A comparison of histogram median and skewness values and spirometry was performed. STATISTICAL TESTS Kruskal-Wallis tests with Dunn's multiple comparison tests to compare VOLVE metrics between groups; Spearman correlation to assess the correlation between MRI and spirometry-derived parameters; and Bland-Altman analysis and coefficient of variation to evaluate repeatability were used. A P-value <0.05 was considered significant. RESULTS Significant differences between the groups were found for ventilation between healthy never-smoker and COPD groups (median XCCV, LagV, and GradV) and perfusion (median XCCQ, LagQ, and GradQ). Minimal bias and no significant differences between intravisit scans were found (P range = 0.12-0.97). DATA CONCLUSION This preliminary study showed that VOLVE has potential to provide metrics of function quantification. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Zachary J T Peggs
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- Centre for Respiratory Research, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jonathan P Brooke
- Centre for Respiratory Research, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Charlotte E Bolton
- Centre for Respiratory Research, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Ian P Hall
- Centre for Respiratory Research, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- Centre for Respiratory Research, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Penny A Gowland
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
- Centre for Respiratory Research, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| |
Collapse
|
3
|
Elbehairy AF, Marshall H, Naish JH, Wild JM, Parraga G, Horsley A, Vestbo J. Advances in COPD imaging using CT and MRI: linkage with lung physiology and clinical outcomes. Eur Respir J 2024; 63:2301010. [PMID: 38548292 DOI: 10.1183/13993003.01010-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/16/2024] [Indexed: 05/04/2024]
Abstract
Recent years have witnessed major advances in lung imaging in patients with COPD. These include significant refinements in images obtained by computed tomography (CT) scans together with the introduction of new techniques and software that aim for obtaining the best image whilst using the lowest possible radiation dose. Magnetic resonance imaging (MRI) has also emerged as a useful radiation-free tool in assessing structural and more importantly functional derangements in patients with well-established COPD and smokers without COPD, even before the existence of overt changes in resting physiological lung function tests. Together, CT and MRI now allow objective quantification and assessment of structural changes within the airways, lung parenchyma and pulmonary vessels. Furthermore, CT and MRI can now provide objective assessments of regional lung ventilation and perfusion, and multinuclear MRI provides further insight into gas exchange; this can help in structured decisions regarding treatment plans. These advances in chest imaging techniques have brought new insights into our understanding of disease pathophysiology and characterising different disease phenotypes. The present review discusses, in detail, the advances in lung imaging in patients with COPD and how structural and functional imaging are linked with common resting physiological tests and important clinical outcomes.
Collapse
Affiliation(s)
- Amany F Elbehairy
- Department of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Helen Marshall
- POLARIS, Imaging, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Josephine H Naish
- MCMR, Manchester University NHS Foundation Trust, Manchester, UK
- Bioxydyn Limited, Manchester, UK
| | - Jim M Wild
- POLARIS, Imaging, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, Sheffield, UK
| | - Grace Parraga
- Robarts Research Institute, Western University, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
- Division of Respirology, Western University, London, ON, Canada
| | - Alexander Horsley
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| |
Collapse
|
4
|
Papaioannou AI, Hillas G, Loukides S, Vassilakopoulos T. Mortality prevention as the centre of COPD management. ERJ Open Res 2024; 10:00850-2023. [PMID: 38887682 PMCID: PMC11181087 DOI: 10.1183/23120541.00850-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/14/2024] [Indexed: 06/20/2024] Open
Abstract
COPD is a major healthcare problem and cause of mortality worldwide. COPD patients at increased mortality risk are those who are more symptomatic, have lower lung function and lower diffusing capacity of the lung for carbon monoxide, decreased exercise capacity, belong to the emphysematous phenotype and those who have concomitant bronchiectasis. Mortality risk seems to be greater in patients who experience COPD exacerbations and in those who suffer from concomitant cardiovascular and/or metabolic diseases. To predict the risk of death in COPD patients, several composite scores have been created using different parameters. In previous years, large studies (also called mega-trials) have evaluated the efficacy of different therapies on COPD mortality, but until recently only nonpharmaceutical interventions have proven to be effective. However, recent studies on fixed combinations of triple therapy (long-acting β-agonists, long-acting muscarinic antagonists and inhaled corticosteroids) have provided encouraging results, showing for the first time a reduction in mortality compared to dual therapies. The aim of the present review is to summarise available data regarding mortality risk in COPD patients and to describe pharmacological therapies that have shown effectiveness in reducing mortality.
Collapse
Affiliation(s)
- Andriana I. Papaioannou
- 1st Department of Pulmonary Medicine, National and Kapodistrian University of Athens, Medical School, “Sotiria” Chest Hospital, Athens, Greece
| | - Georgios Hillas
- 5th Pulmonary Department, “Sotiria” Chest Hospital, Athens, Greece
| | - Stelios Loukides
- National and Kapodistrian University of Athens, Medical School, 2nd Respiratory Medicine Department, Attikon University Hospital, Athens, Greece
| | - Theodoros Vassilakopoulos
- National and Kapodistrian University of Athens, Laboratory of Physiology, Medical School of NKUA, Critical Care and Pulmonary (2nd) Department, Henry Dunant Hospital Center, Athens, Greece
| |
Collapse
|
5
|
Dohna M, Voskrebenzev A, Klimeš F, Kaireit TF, Glandorf J, Pallenberg ST, Ringshausen FC, Hansen G, Renz DM, Wacker F, Dittrich AM, Vogel-Claussen J. PREFUL MRI for Monitoring Perfusion and Ventilation Changes after Elexacaftor-Tezacaftor-Ivacaftor Therapy for Cystic Fibrosis: A Feasibility Study. Radiol Cardiothorac Imaging 2024; 6:e230104. [PMID: 38573129 PMCID: PMC11056757 DOI: 10.1148/ryct.230104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 01/18/2024] [Accepted: 02/07/2024] [Indexed: 04/05/2024]
Abstract
Purpose To assess the feasibility of monitoring the effects of elexacaftor-tezacaftor-ivacaftor (ETI) therapy on lung ventilation and perfusion in people with cystic fibrosis (CF), using phase-resolved functional lung (PREFUL) MRI. Materials and Methods This secondary analysis of a multicenter prospective study was carried out between August 2020 and March 2021 and included participants 12 years or older with CF who underwent PREFUL MRI, spirometry, sweat chloride test, and lung clearance index assessment before and 8-16 weeks after ETI therapy. For PREFUL-derived ventilation and perfusion parameter extraction, two-dimensional coronal dynamic gradient-echo MR images were evaluated with an automated quantitative pipeline. T1- and T2-weighted MR images and PREFUL perfusion maps were visually assessed for semiquantitative Eichinger scores. Wilcoxon signed rank test compared clinical parameters and PREFUL values before and after ETI therapy. Correlation of parameters was calculated as Spearman ρ correlation coefficient. Results Twenty-three participants (median age, 18 years [IQR: 14-24.5 years]; 13 female) were included. Quantitative PREFUL parameters, Eichinger score, and clinical parameters (lung clearance index = 21) showed significant improvement after ETI therapy. Ventilation defect percentage of regional ventilation decreased from 18% (IQR: 14%-25%) to 9% (IQR: 6%-17%) (P = .003) and perfusion defect percentage from 26% (IQR: 18%-36%) to 19% (IQR: 13%-24%) (P = .002). Areas of matching normal (healthy) ventilation and perfusion increased from 52% (IQR: 47%-68%) to 73% (IQR: 61%-83%). Visually assessed perfusion scores did not correlate with PREFUL perfusion (P = .11) nor with ventilation-perfusion match values (P = .38). Conclusion The study demonstrates the feasibility of PREFUL MRI for semiautomated quantitative assessment of perfusion and ventilation changes in response to ETI therapy in people with CF. Keywords: Pediatrics, MR-Functional Imaging, Pulmonary, Lung, Comparative Studies, Cystic Fibrosis, Elexacaftor-Tezacaftor-Ivacaftor Therapy, Fourier Decomposition, PREFUL, Free-Breathing Proton MRI, Pulmonary MRI, Perfusion, Functional MRI, CFTR, Modulator Therapy, Kaftrio Clinical trial registration no. NCT04732910 Supplemental material is available for this article. © RSNA, 2024.
Collapse
Affiliation(s)
- Martha Dohna
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Andreas Voskrebenzev
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Filip Klimeš
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Till F. Kaireit
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Julian Glandorf
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Sophia T. Pallenberg
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Felix C. Ringshausen
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Gesine Hansen
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Diane Miriam Renz
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | - Frank Wacker
- From the Department of Diagnostic and Interventional Radiology (M.D.,
A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research
(DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)
(A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.),
Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H.,
A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover
Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European
Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG),
Frankfurt, Germany (F.C.R.)
| | | | | |
Collapse
|
6
|
Wernz MM, Voskrebenzev A, Müller RA, Zubke M, Klimeš F, Glandorf J, Czerner C, Wacker F, Olsson KM, Hoeper MM, Hohlfeld JM, Vogel-Claussen J. Feasibility, Repeatability, and Correlation to Lung Function of Phase-Resolved Functional Lung (PREFUL) MRI-derived Pulmonary Artery Pulse Wave Velocity Measurements. J Magn Reson Imaging 2024. [PMID: 38460124 DOI: 10.1002/jmri.29337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Pulse wave velocity (PWV) in the pulmonary arteries (PA) is a marker of vascular stiffening. Currently, only phase-contrast (PC) MRI-based options exist to measure PA-PWV. PURPOSE To test feasibility, repeatability, and correlation to clinical data of Phase-Resolved Functional Lung (PREFUL) MRI-based calculation of PA-PWV. STUDY TYPE Retrospective. SUBJECTS 79 (26 female) healthy subjects (age range 19-78), 58 (24 female) patients with chronic obstructive pulmonary disease (COPD, age range 40-77), 60 (33 female) patients with suspected pulmonary hypertension (PH, age range 28-85). SEQUENCE 2D spoiled gradient echo, 1.5T. ASSESSMENT PA-PWV was measured from PREFUL-derived cardiac cycles based on the determination of temporal and spatial distance between lung vasculature voxels using a simplified (sPWV) method and a more comprehensive (cPWV) method including more elaborate distance calculation. For 135 individuals, PC MRI-based PWV (PWV-QA) was measured. STATISTICAL TESTS Intraclass-correlation-coefficient (ICC) and coefficient of variation (CoV) were used to test repeatability. Nonparametric tests were used to compare cohorts. Correlation of sPWV/cPWV, PWV-QA, forced expiratory volume in 1 sec (FEV1 ) %predicted, residual volume (RV) %predicted, age, and right heart catheterization (RHC) data were tested. Significance level α = 0.05 was used. RESULTS sPWV and cPWV showed no significant differences between repeated measurements (P-range 0.10-0.92). CoV was generally lower than 15%. COPD and PH patients had significantly higher sPWV and cPWV than healthy subjects. Significant correlation was found between sPWV or cPWV and FEV1 %pred. (R = -0.36 and R = -0.44), but not with RHC (P-range -0.11 - 0.91) or age (P-range 0.23-0.89). Correlation to RV%pred. was significant for cPWV (R = 0.42) but not for sPWV (R = 0.34, P = 0.055). For all cohorts, sPWV and cPWV were significantly correlated with PWV-QA (R = -0.41 and R = 0.48). DATA CONCLUSION PREFUL-derived PWV is feasible and repeatable. PWV is increased in COPD and PH patients and correlates to airway obstruction and hyperinflation. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Marius M Wernz
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Robin A Müller
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Maximilian Zubke
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Filip Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Julian Glandorf
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Christoph Czerner
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Karen M Olsson
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany
| | - Marius M Hoeper
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany
| | - Jens M Hohlfeld
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Jens Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| |
Collapse
|
7
|
Friedlander Y, Munidasa S, Thakar A, Ragunayakam N, Venegas C, Kjarsgaard M, Zanette B, Capaldi DPI, Santyr G, Nair P, Svenningsen S. Phase-Resolved Functional Lung (PREFUL) MRI to Quantify Ventilation: Feasibility and Physiological Relevance in Severe Asthma. Acad Radiol 2024:S1076-6332(24)00061-8. [PMID: 38378325 DOI: 10.1016/j.acra.2024.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/28/2024] [Accepted: 01/28/2024] [Indexed: 02/22/2024]
Abstract
RATIONALE AND OBJECTIVES Emergent evidence in several respiratory diseases supports translational potential for Phase-Resolved Functional Lung (PREFUL) MRI to spatially quantify ventilation but its feasibility and physiological relevance have not been demonstrated in patients with asthma. This study compares PREFUL-derived ventilation defect percent (VDP) in severe asthma patients to healthy controls and measures its responsiveness to bronchodilator therapy and relation to established measures of airways disease. MATERIALS AND METHODS Forty-one adults with severe asthma and seven healthy controls performed same-day free-breathing 1H MRI, 129Xe MRI, spirometry, and oscillometry. A subset of participants (n = 23) performed chest CT and another subset of participants with asthma (n = 19) repeated 1H MRI following the administration of a bronchodilator. VDP was calculated for both PREFUL and 129Xe MRI. Additionally, the percent of functional small airways disease was determined from CT parametric response maps (PRMfSAD). RESULTS PREFUL VDP measured pre-bronchodilator (19.1% [7.4-43.3], p = 0.0002) and post-bronchodilator (16.9% [6.1-38.4], p = 0.0007) were significantly greater than that of healthy controls (7.5% [3.7-15.5]) and was significantly decreased post-bronchodilator (from 21.9% [10.1-36.9] to 16.9% [6.1-38.4], p = 0.0053). PREFUL VDP was correlated with spirometry (FEV1%pred: r = -0.46, p = 0.0023; FVC%pred: r = -0.35, p = 0.024, FEV1/FVC: r = -0.46, p = 0.0028), 129Xe MRI VDP (r = 0.39, p = 0.013), and metrics of small airway disease (CT PRMfSAD: r = 0.55, p = 0.021; Xrs5 Hz: r = -0.44, p = 0.0046, and AX: r = 0.32, p = 0.044). CONCLUSION PREFUL-derived VDP is responsive to bronchodilator therapy in asthma and is associated with measures of airflow obstruction and small airway dysfunction. These findings validate PREFUL VDP as a physiologically relevant and accessible ventilation imaging outcome measure in asthma.
Collapse
Affiliation(s)
- Yonni Friedlander
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Samal Munidasa
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Ashutosh Thakar
- Department of Medicine, McMaster University, Hamilton, Canada
| | | | - Carmen Venegas
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada
| | - Melanie Kjarsgaard
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada
| | - Brandon Zanette
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada
| | - Dante P I Capaldi
- Department of Radiation Oncology, Division of Physics, University of California, San Francisco, CA
| | - Giles Santyr
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Parameswaran Nair
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada
| | - Sarah Svenningsen
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
| |
Collapse
|
8
|
Kay FU, Madhuranthakam AJ. MR Perfusion Imaging of the Lung. Magn Reson Imaging Clin N Am 2024; 32:111-123. [PMID: 38007274 DOI: 10.1016/j.mric.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Lung perfusion assessment is critical for diagnosing and monitoring a variety of respiratory conditions. MRI perfusion provides a radiation-free technique, making it an ideal choice for longitudinal imaging in younger populations. This review focuses on the techniques and applications of MRI perfusion, including contrast-enhanced (CE) MRI and non-CE methods such as arterial spin labeling (ASL), fourier decomposition (FD), and hyperpolarized 129-Xenon (129-Xe) MRI. ASL leverages endogenous water protons as tracers for a non-invasive measure of lung perfusion, while FD offers simultaneous measurements of lung perfusion and ventilation, enabling the generation of ventilation/perfusion mapsHyperpolarized 129-Xe MRI emerges as a novel tool for assessing regional gas exchange in the lungs. Despite the promise of MRI perfusion techniques, challenges persist, including competition with other imaging techniques and the need for additional validation and standardization. In conditions such as cystic fibrosis and lung cancer, MRI has displayed encouraging results, whereas in diseases like chronic obstructive pulmonary disease, further validation remains necessary. In conclusion, while MRI perfusion techniques hold immense potential for a comprehensive, non-invasive assessment of lung function and perfusion, their broader clinical adoption hinges on technological advancements, collaborative research, and rigorous validation.
Collapse
Affiliation(s)
- Fernando U Kay
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
| | - Ananth J Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, North Campus 2201 Inwood Road, Dallas, TX 75390-8568, USA
| |
Collapse
|
9
|
Klimeš F, Obert AJ, Scheller J, Wernz MM, Voskrebenzev A, Gutberlet M, Grimm R, Suhling H, Müller RA, Kaireit TF, Glandorf J, Moher Alsady T, Wacker F, Vogel-Claussen J. Comparison of Free-Breathing 3D Phase-Resolved Functional Lung (PREFUL) MRI With Dynamic 19 F Ventilation MRI in Patients With Obstructive Lung Disease and Healthy Volunteers. J Magn Reson Imaging 2024. [PMID: 38214459 DOI: 10.1002/jmri.29221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Non-contrast-enhanced 1 H magnetic resonance imaging (MRI) with full lung coverage shows promise for assessment of regional lung ventilation but a comparison with direct ventilation measurement using 19 F MRI is lacking. PURPOSE To compare ventilation parameters calculated using 3D phase-resolved functional lung (PREFUL) MRI with 19 F MRI. STUDY TYPE Prospective. POPULATION Fifteen patients with asthma, 14 patients with chronic obstructive lung disease, and 13 healthy volunteers. FIELD STRENGTH/SEQUENCE A 3D gradient-echo pulse sequence with golden-angle increment and stack-of-stars encoding at 1.5 T. ASSESSMENT All participants underwent 3D PREFUL MRI and 19 F MRI. For 3D PREFUL, static regional ventilation (RVent) and dynamic flow-volume cross-correlation metric (FVL-CM) were calculated. For both parameters, ventilation defect percentage (VDP) values and ventilation defect (VD) maps (including a combination of both parameters [VDPCombined ]) were determined. For 19 F MRI, images from eight consecutive breaths under volume-controlled inhalation of perfluoropropane were acquired. Time-to-fill (TTF) and wash-in (WI) parameters were extracted. For all 19 F parameters, a VD map was generated and the corresponding VDP values were calculated. STATISTICAL TESTS For all parameters, the relationship between the two techniques was assessed using a Spearman correlation (r). Differences between VDP values were compared using Bland-Altman analysis. For regional comparison of VD maps, spatial overlap and Sørensen-Dice coefficients were computed. RESULTS 3D PREFUL VDP values were significantly correlated to VDP measures by 19 F (r range: 0.59-0.70). For VDPRVent , no significant bias was observed with VDP of the third and fourth breath (bias range = -6.8:7.7%, P range = 0.25:0.30). For VDPFVL-CM , no significant bias was found with VDP values of fourth-eighth breaths (bias range = -2.0:12.5%, P range = 0.12:0.75). The overall spatial overlap of all VD maps increased with each breath, ranging from 61% to 81%, stabilizing at the fourth breath. DATA CONCLUSION 3D PREFUL MRI parameters showed moderate to strong correlation with 19 F MRI. Depending on the 3D PREFUL VD map, the best regional agreement was found to 19 F VD maps of third-fifth breath. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Filip Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Arnd J Obert
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Julienne Scheller
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Marius M Wernz
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Andreas Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Marcel Gutberlet
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Robert Grimm
- MR Application Predevelopment, Siemens Healthineers AG, Erlangen, Germany
| | - Hendrik Suhling
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
- Department of Respiratory Medicine, Hannover Medical School, Hanover, Germany
| | - Robin A Müller
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Till F Kaireit
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Julian Glandorf
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Tawfik Moher Alsady
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Jens Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| |
Collapse
|
10
|
Mastrodicasa D, Aquino GJ, Ordovas KG, Vargas D, Fleischmann D, Abbara S, Hanneman K. Radiology: Cardiothoracic Imaging Highlights 2022. Radiol Cardiothorac Imaging 2023; 5:e230042. [PMID: 37404783 PMCID: PMC10316293 DOI: 10.1148/ryct.230042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/07/2023] [Accepted: 05/08/2023] [Indexed: 07/06/2023]
Abstract
Since its inaugural issue in 2019, Radiology: Cardiothoracic Imaging has disseminated the latest scientific advances and technical developments in cardiac, vascular, and thoracic imaging. In this review, we highlight select articles published in this journal between October 2021 and October 2022. The scope of the review encompasses various aspects of coronary artery and congenital heart diseases, vascular diseases, thoracic imaging, and health services research. Key highlights include changes in the revised Coronary Artery Disease Reporting and Data System 2.0, the value of coronary CT angiography in informing prognosis and guiding treatment decisions, cardiac MRI findings after COVID-19 vaccination or infection, high-risk features at CT angiography to identify patients with aortic dissection at risk for late adverse events, and CT-guided fiducial marker placement for preoperative planning for pulmonary nodules. Ongoing research and future directions include photon-counting CT and artificial intelligence applications in cardiovascular imaging. Keywords: Pediatrics, CT Angiography, CT-Perfusion, CT-Spectral Imaging, MR Angiography, PET/CT, Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR), Cardiac, Pulmonary, Vascular, Aorta, Coronary Arteries © RSNA, 2023.
Collapse
|
11
|
Munidasa S, Zanette B, Couch M, Grimm R, Seethamraju R, Dumas MP, Wee W, Au J, Braganza S, Li D, Woods J, Ratjen F, Santyr G. Inter- and intravisit repeatability of free-breathing MRI in pediatric cystic fibrosis lung disease. Magn Reson Med 2023; 89:2048-2061. [PMID: 36576212 DOI: 10.1002/mrm.29566] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE The purpose of this study is to assess the intra- and interscan repeatability of free-breathing phase-resolved functional lung (PREFUL) MRI in stable pediatric cystic fibrosis (CF) lung disease in comparison to static breath-hold hyperpolarized 129-xenon MRI (Xe-MRI) and pulmonary function tests. METHODS Free-breathing 1-hydrogen MRI and Xe-MRI were acquired from 15 stable pediatric CF patients and seven healthy age-matched participants on two visits, 1 month apart. Same-visit MRI scans were also performed on a subgroup of the CF patients. Following the PREFUL algorithm, regional ventilation (RVent) and regional flow volume loop cross-correlation maps were determined from the free-breathing data. Ventilation defect percentage (VDP) was determined from RVent maps (VDPRVent ), regional flow volume loop cross-correlation maps (VDPCC ), VDPRVent ∪ VDPCC , and multi-slice Xe-MRI. Repeatability was evaluated using Bland-Altman analysis, coefficient of repeatability (CR), and intraclass correlation. RESULTS Minimal bias and no significant differences were reported for all PREFUL MRI and Xe-MRI VDP parameters between intra- and intervisits (all P > 0.05). Repeatability of VDPRVent , VDPCC , VDPRVent ∪ VDPCC , and multi-slice Xe-MRI were lower between the two-visit scans (CR = 14.81%, 15.36%, 16.19%, and 9.32%, respectively) in comparison to the same-day scans (CR = 3.38%, 2.90%, 1.90%, and 3.92%, respectively). pulmonary function tests showed high interscan repeatability relative to PREFUL MRI and Xe-MRI. CONCLUSION PREFUL MRI, similar to Xe-MRI, showed high intravisit repeatability but moderate intervisit repeatability in CF, which may be due to inherent disease instability, even in stable patients. Thus, PREFUL MRI may be considered a suitable outcome measure for future treatment response studies.
Collapse
Affiliation(s)
- Samal Munidasa
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Brandon Zanette
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marcus Couch
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Siemens Healthcare Limited, Montreal, Quebec, Canada
| | - Robert Grimm
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Ravi Seethamraju
- MR Collaborations North East, Siemens Healthineers, Malvern, Pennsylvania, USA
| | - Marie-Pier Dumas
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wallace Wee
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jacky Au
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon Braganza
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daniel Li
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jason Woods
- Center for Pulmonary Imaging Research, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Felix Ratjen
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giles Santyr
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
12
|
Klimeš F, Voskrebenzev A, Gutberlet M, Grimm R, Wacker F, Vogel-Claussen J. Evaluation of image registration algorithms for 3D phase-resolved functional lung ventilation magnetic resonance imaging in healthy volunteers and chronic obstructive pulmonary disease patients. NMR IN BIOMEDICINE 2023; 36:e4860. [PMID: 36285811 DOI: 10.1002/nbm.4860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
The purpose of the current study was to assess the influence of the registration algorithms on the repeatability of three-dimensional (3D) phase-resolved functional lung (PREFUL) ventilation magnetic resonance imaging (MRI). Twenty-three healthy volunteers and 10 patients with chronic obstructive pulmonary disease (COPD) underwent 3D PREFUL MRI during tidal breathing. The registration of dynamically acquired data to a fixed image was executed using single-step, stepwise, and group-oriented registration (GOREG) approaches. Advanced Normalization Tools (ANTs) and the Forsberg image-registration package were used for the registration. Image registration algorithms were tested for differences and evaluated by the repeatability analysis of ventilation parameters using coefficient of variation (CoV), intraclass-correlation coefficient, Bland-Altman plots, and correlation to spirometry. Also, the registration time and image quality were computed for all registration approaches. Very strong to strong correlations (r range: 0.917-0.999) were observed between ventilation parameters derived using various registration approaches. Median CoV values of the cross-correlation (CC) parameter were significantly lower (all p ≤ 0.0054) for ANTs GOREG compared with single-step and stepwise ANTs registration. The majority of comparisons between COPD patients and age-matched healthy volunteers showed agreement among the registration approaches. The repeatability of regional ventilation (RVent)-based ventilation defect percentage (VDPRVent ) and VDPCC was significantly higher (both p ≤ 0.0054) for Forsberg GOREG compared with ANTs GOREG. All 3D PREFUL-derived ventilation parameters correlated with forced expiratory volume in 1 s (FEV1 ) and the FEV1 / forced vital capacity (FVC) ratio (all |r| > 0.40, all p < 0.03). The image sharpness of RVent maps was statistically elevated (all p < 0.001) using GOREG compared with single-step and stepwise registration approaches using ANTs. The best computational performance was achieved with Forsberg GOREG. The GOREG scheme improves the repeatability and image quality of dynamic 3D PREFUL ventilation parameters. Registration time can be ~10-fold reduced to 9 min using the Forsberg method with equal or even improved repeatability and comparable PREFUL ventilation results compared with the ANTs method.
Collapse
Affiliation(s)
- Filip Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Marcel Gutberlet
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Robert Grimm
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| |
Collapse
|