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Dournes G, Benlala I. Hierarchical Computed Tomography Scoring Systems Cannot Discriminate Between Reversible Bronchiectasis and Mucus Plugs. Am J Respir Crit Care Med 2024; 209:1038-1039. [PMID: 38354402 DOI: 10.1164/rccm.202311-2124le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/13/2024] [Indexed: 02/16/2024] Open
Affiliation(s)
- Gaël Dournes
- University Bordeaux and
- Institut National de la Santé Et de la Recherche Médicale, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France; and
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | - Ilyes Benlala
- University Bordeaux and
- Institut National de la Santé Et de la Recherche Médicale, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France; and
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
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Benlala I, Klaar R, Gaass T, Macey J, Bui S, Senneville BDD, Berger P, Laurent F, Dournes G, Dinkel J. Non-Contrast-Enhanced Functional Lung MRI to Evaluate Treatment Response of Allergic Bronchopulmonary Aspergillosis in Patients With Cystic Fibrosis: A Pilot Study. J Magn Reson Imaging 2024; 59:909-919. [PMID: 37265441 DOI: 10.1002/jmri.28844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) patients is associated with severe lung damage and requires specific therapeutic management. Repeated imaging is recommended to both diagnose and follow-up response to treatment of ABPA in CF. However, high risk of cumulative radiation exposure requires evaluation of free-radiation techniques in the follow-up of CF patients with ABPA. PURPOSE To evaluate whether Fourier decomposition (FD) functional lung MRI can detect response to treatment of ABPA in CF patients. STUDY TYPE Retrospective longitudinal. POPULATION Twelve patients (7M, median-age:14 years) with CF and ABPA with pre- and post-treatment MRI. FIELD STRENGTH/SEQUENCE 2D-balanced-steady-state free-precession (bSSFP) sequence with FD at 1.5T. ASSESSMENT Ventilation-weighted (V) and perfusion-weighted (Q) maps were obtained after FD processing of 2D-coronal bSSFP time-resolved images acquired before and 3-9 months after treatment. Defects extent was assessed on the functional maps using a qualitative semi-quantitative score (0 = absence/negligible, 1 = <50%, 2 = >50%). Mean and coefficient of variation (CV) of the ventilation signal-intensity (VSI) and the perfusion signal-intensity (QSI) were calculated. Measurements were performed independently by three readers and averaged. Inter-reader reproducibility of the measurements was assessed. Pulmonary function tests (PFTs) were performed within 1 week of both MRI studies as markers of the airflow-limitation severity. STATISTICAL TESTS Comparisons of medians were performed using the paired Wilcoxon-test. Reproducibility was assessed using intraclass correlation coefficient (ICC). Correlations between MRI and PFT parameters were assessed using the Spearman-test (rho correlation-coefficient). A P-value <0.05 was considered as significant. RESULTS Defects extent on both V and Q maps showed a significant reduction after ABPA treatment (4.25 vs. 1.92 for V-defect-score and 5 vs. 2.75 for Q-defect-score). VSI_mean was significantly increased after treatment (280 vs. 167). Qualitative analyses reproducibility showed an ICC > 0.90, while the ICCs of the quantitative measurements was almost perfect (>0.99). Changes in VSI_cv and QSI_cv before and after treatment correlated inversely with changes of FEV1%p (rho = -0.68 for both). DATA CONCLUSION Non-contrast-enhanced FD lung MRI has potential to reproducibly assess response to treatment of ABPA in CF patients and correlates with PFT obstructive parameters. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Ilyes Benlala
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Pessac, France
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-thoracique de Bordeaux, Pessac, France
| | - Rabea Klaar
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Thomas Gaass
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Julie Macey
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Stéphanie Bui
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | | | - Patrick Berger
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Pessac, France
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - François Laurent
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Pessac, France
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Gael Dournes
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Pessac, France
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Julien Dinkel
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
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Laurent F, Benlala I, Dournes G. Radiological Diagnosis of Pulmonary Aspergillosis. Semin Respir Crit Care Med 2024; 45:50-60. [PMID: 38286137 DOI: 10.1055/s-0043-1776998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Imaging plays an important role in the various forms of Aspergillus-related pulmonary disease. Depending on the immune status of the patient, three forms are described with distinct imaging characteristics: invasive aspergillosis affecting severely immunocompromised patients, chronic pulmonary aspergillosis affecting less severely immunocompromised patients but suffering from a pre-existing structural lung disease, and allergic bronchopulmonary aspergillosis related to respiratory exposure to Aspergillus species in patients with asthma and cystic fibrosis. Computed tomography (CT) has been demonstrated more sensitive and specific than chest radiographs and its use has largely contributed to the diagnosis, follow-up, and evaluation of treatment in each condition. In the last few decades, CT has also been described in the specific context of cystic fibrosis. In this particular clinical setting, magnetic resonance imaging and the recent developments in artificial intelligence have shown promising results.
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Affiliation(s)
- François Laurent
- Centre de Recherche Cardio-thoracique de Bordeaux, University of Bordeaux, Pessac, France
| | - Ilyes Benlala
- Centre de Recherche Cardio-thoracique de Bordeaux, University of Bordeaux, Pessac, France
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Centre de Recherche Cardio-thoracique de Bordeaux, University of Bordeaux, Pessac, France
| | - Gael Dournes
- Centre de Recherche Cardio-thoracique de Bordeaux, University of Bordeaux, Pessac, France
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Centre de Recherche Cardio-thoracique de Bordeaux, University of Bordeaux, Pessac, France
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Zysman M, Asselineau J, Saut O, Frison E, Oranger M, Maurac A, Charriot J, Achkir R, Regueme S, Klein E, Bommart S, Bourdin A, Dournes G, Casteigt J, Blum A, Ferretti G, Degano B, Thiébaut R, Chabot F, Berger P, Laurent F, Benlala I. Development and external validation of a prediction model for the transition from mild to moderate or severe form of COVID-19. Eur Radiol 2023; 33:9262-9274. [PMID: 37405504 PMCID: PMC10667132 DOI: 10.1007/s00330-023-09759-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/22/2023] [Accepted: 04/04/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVES COVID-19 pandemic seems to be under control. However, despite the vaccines, 5 to 10% of the patients with mild disease develop moderate to critical forms with potential lethal evolution. In addition to assess lung infection spread, chest CT helps to detect complications. Developing a prediction model to identify at-risk patients of worsening from mild COVID-19 combining simple clinical and biological parameters with qualitative or quantitative data using CT would be relevant to organizing optimal patient management. METHODS Four French hospitals were used for model training and internal validation. External validation was conducted in two independent hospitals. We used easy-to-obtain clinical (age, gender, smoking, symptoms' onset, cardiovascular comorbidities, diabetes, chronic respiratory diseases, immunosuppression) and biological parameters (lymphocytes, CRP) with qualitative or quantitative data (including radiomics) from the initial CT in mild COVID-19 patients. RESULTS Qualitative CT scan with clinical and biological parameters can predict which patients with an initial mild presentation would develop a moderate to critical form of COVID-19, with a c-index of 0.70 (95% CI 0.63; 0.77). CT scan quantification improved the performance of the prediction up to 0.73 (95% CI 0.67; 0.79) and radiomics up to 0.77 (95% CI 0.71; 0.83). Results were similar in both validation cohorts, considering CT scans with or without injection. CONCLUSION Adding CT scan quantification or radiomics to simple clinical and biological parameters can better predict which patients with an initial mild COVID-19 would worsen than qualitative analyses alone. This tool could help to the fair use of healthcare resources and to screen patients for potential new drugs to prevent a pejorative evolution of COVID-19. CLINICAL TRIAL REGISTRATION NCT04481620. CLINICAL RELEVANCE STATEMENT CT scan quantification or radiomics analysis is superior to qualitative analysis, when used with simple clinical and biological parameters, to determine which patients with an initial mild presentation of COVID-19 would worsen to a moderate to critical form. KEY POINTS • Qualitative CT scan analyses with simple clinical and biological parameters can predict which patients with an initial mild COVID-19 and respiratory symptoms would worsen with a c-index of 0.70. • Adding CT scan quantification improves the performance of the clinical prediction model to an AUC of 0.73. • Radiomics analyses slightly improve the performance of the model to a c-index of 0.77.
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Affiliation(s)
- Maéva Zysman
- CHU Bordeaux, 33600, Pessac, France.
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, 33600, Bordeaux, France.
- Centre de Recherche Cardio-Thoracique de Bordeaux (U1045), Centre d'Investigation Clinique, INSERM, Bordeaux Population Health (U1219), (CIC-P 1401), 33600, Pessac, France.
| | | | - Olivier Saut
- "Institut de Mathématiques de Bordeaux" (IMB), UMR5251, CNRS, University of Bordeaux, 351 Cours Libération, 33400, Talence, France
- MONC Team & SISTM Team, INRIA Bordeaux Sud-Ouest, 200 Av Vieille Tour, 33400, Talence, France
| | | | - Mathilde Oranger
- Pôle Des Spécialités Médicales/Département de Pneumologie, Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Service de Radiologie Et d'Imagerie, Nancy, France
- Faculté de Médecine de Nancy, Université de Lorraine, Institut National de La Santé Et de La Recherche Médicale (INSERM) Unité Médicale de Recherche (UMR), S 1116, Vandœuvre-Lès-Nancy, France
| | - Arnaud Maurac
- CHU Bordeaux, 33600, Pessac, France
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, 33600, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux (U1045), Centre d'Investigation Clinique, INSERM, Bordeaux Population Health (U1219), (CIC-P 1401), 33600, Pessac, France
| | - Jeremy Charriot
- Department of Respiratory Diseases, Arnaud de Villeneuve Hospital, Montpellier University Hospital, CEDEX 5, 34295, Montpellier, France
- PhyMedExp, University of Montpellier, INSERM U1046, CEDEX 5, 34295, Montpellier, France
| | | | | | | | - Sébastien Bommart
- Department of Respiratory Diseases, Arnaud de Villeneuve Hospital, Montpellier University Hospital, CEDEX 5, 34295, Montpellier, France
- PhyMedExp, University of Montpellier, INSERM U1046, CEDEX 5, 34295, Montpellier, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases, Arnaud de Villeneuve Hospital, Montpellier University Hospital, CEDEX 5, 34295, Montpellier, France
- PhyMedExp, University of Montpellier, INSERM U1046, CEDEX 5, 34295, Montpellier, France
| | - Gael Dournes
- CHU Bordeaux, 33600, Pessac, France
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, 33600, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux (U1045), Centre d'Investigation Clinique, INSERM, Bordeaux Population Health (U1219), (CIC-P 1401), 33600, Pessac, France
| | | | - Alain Blum
- Pôle Des Spécialités Médicales/Département de Pneumologie, Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Service de Radiologie Et d'Imagerie, Nancy, France
| | - Gilbert Ferretti
- France Service de Radiologie Diagnostique Et Interventionnelle, Université Grenoble Alpes, CHU Grenoble-Alpes, Grenoble, France
| | - Bruno Degano
- France Service de Radiologie Diagnostique Et Interventionnelle, Université Grenoble Alpes, CHU Grenoble-Alpes, Grenoble, France
| | - Rodolphe Thiébaut
- CHU Bordeaux, 33600, Pessac, France
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, 33600, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux (U1045), Centre d'Investigation Clinique, INSERM, Bordeaux Population Health (U1219), (CIC-P 1401), 33600, Pessac, France
- MONC Team & SISTM Team, INRIA Bordeaux Sud-Ouest, 200 Av Vieille Tour, 33400, Talence, France
| | - Francois Chabot
- Pôle Des Spécialités Médicales/Département de Pneumologie, Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Service de Radiologie Et d'Imagerie, Nancy, France
- Faculté de Médecine de Nancy, Université de Lorraine, Institut National de La Santé Et de La Recherche Médicale (INSERM) Unité Médicale de Recherche (UMR), S 1116, Vandœuvre-Lès-Nancy, France
| | - Patrick Berger
- CHU Bordeaux, 33600, Pessac, France
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, 33600, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux (U1045), Centre d'Investigation Clinique, INSERM, Bordeaux Population Health (U1219), (CIC-P 1401), 33600, Pessac, France
| | - Francois Laurent
- CHU Bordeaux, 33600, Pessac, France
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, 33600, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux (U1045), Centre d'Investigation Clinique, INSERM, Bordeaux Population Health (U1219), (CIC-P 1401), 33600, Pessac, France
| | - Ilyes Benlala
- CHU Bordeaux, 33600, Pessac, France
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, 33600, Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux (U1045), Centre d'Investigation Clinique, INSERM, Bordeaux Population Health (U1219), (CIC-P 1401), 33600, Pessac, France
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David M, Benlala I, Bui S, Benkert T, Berger P, Laurent F, Macey J, Dournes G. Longitudinal Evaluation of Bronchial Changes in Cystic Fibrosis Patients Undergoing Elexacaftor/Tezacaftor/Ivacaftor Therapy Using Lung MRI With Ultrashort Echo-Times. J Magn Reson Imaging 2023. [PMID: 37861357 DOI: 10.1002/jmri.29041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Lung magnetic resonance imaging (MRI) with ultrashort echo-times (UTE-MRI) allows high-resolution and radiation-free imaging of the lung structure in cystic fibrosis (CF). In addition, the combination of elexacaftor/tezacaftor/ivacaftor (ETI) has improved CF clinical outcomes such as need for hospitalization. However, the effect on structural disease still needs longitudinal evaluation at high resolution. PURPOSE To analyze the effects of ETI on lung structural alterations using UTE-MRI, with a focus on bronchiectasis reversibility. STUDY TYPE Retrospective. POPULATION Fifty CF patients (mean age 24.3 ± 9.2; 23 males). FIELD STRENGTH/SEQUENCE 1.5 T, UTE-MRI. ASSESSMENT All subjects completed both UTE-MRI and pulmonary function tests (PFTs) during two annual visits (M0 and M12), and 30 of them completed a CT scan. They initiated ETI treatment after M0 within a maximum of 3 months from the annual examinations. Three observers scored a clinical MRI Bhalla score on UTE-MRI. Bronchiectasis reversibility was defined as a reduction in both outer and inner bronchial dimensions. Correlations were searched between the Bhalla score and PFT such as the forced expiratory volume in 1 second percentage predicted (FEV1%p). STATISTICAL TESTS Comparison was assessed using the paired t-test, correlation using the Spearman correlation test with a significance level of 0.05. Concordance and reproducibility were assessed using intraclass correlation coefficient (ICC). RESULTS There was a significant improvement in MRI Bhalla score after ETI treatment. UTE-MRI demonstrated bronchiectasis reversibility in a subgroup of 18 out of 50 CF patients (36%). These patients with bronchiectasis reversibility were significantly younger, with lower severity of wall thickening but no difference in mucus plugging extent (P = 0.39) was found. The reproducibility of UTE-MRI evaluations was excellent (ICC ≥ 0.95), was concordant with CT scan (N = 30; ICC ≥ 0.90) and significantly correlated to FEV1% at PFT at M0 (N = 50; r = 0.71) and M12 (N = 50; r = 0.72). DATA CONCLUSION UTE-MRI is a reproducible tool for the longitudinal follow-up of CF patients, allowing to quantify the response to ETI and demonstrating the reversibility of some structural alterations such as bronchiectasis in a substantial fraction of this study population. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Mathieu David
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Paediatric Cystic Fibrosis Reference Center (CRCM), Pessac, France
| | - Ilyes Benlala
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Paediatric Cystic Fibrosis Reference Center (CRCM), Pessac, France
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
| | - Stephanie Bui
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Paediatric Cystic Fibrosis Reference Center (CRCM), Pessac, France
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Patrick Berger
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Paediatric Cystic Fibrosis Reference Center (CRCM), Pessac, France
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
| | - François Laurent
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Paediatric Cystic Fibrosis Reference Center (CRCM), Pessac, France
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
| | - Julie Macey
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Paediatric Cystic Fibrosis Reference Center (CRCM), Pessac, France
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
| | - Gael Dournes
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Paediatric Cystic Fibrosis Reference Center (CRCM), Pessac, France
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Pessac, France
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Longuefosse A, Raoult J, Benlala I, Denis de Senneville B, Benkert T, Macey J, Bui S, Berger P, Ferretti G, Gaubert JY, Liberge R, Hutt A, Morel B, Laurent F, Baldacci F, Dournes G. Generating High-Resolution Synthetic CT from Lung MRI with Ultrashort Echo Times: Initial Evaluation in Cystic Fibrosis. Radiology 2023; 308:e230052. [PMID: 37404152 DOI: 10.1148/radiol.230052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Background Lung MRI with ultrashort echo times (UTEs) enables high-resolution and radiation-free morphologic imaging; however, its image quality is still lower than that of CT. Purpose To assess the image quality and clinical applicability of synthetic CT images generated from UTE MRI by a generative adversarial network (GAN). Materials and Methods This retrospective study included patients with cystic fibrosis (CF) who underwent both UTE MRI and CT on the same day at one of six institutions between January 2018 and December 2022. The two-dimensional GAN algorithm was trained using paired MRI and CT sections and tested, along with an external data set. Image quality was assessed quantitatively by measuring apparent contrast-to-noise ratio, apparent signal-to-noise ratio, and overall noise and qualitatively by using visual scores for features including artifacts. Two readers evaluated CF-related structural abnormalities and used them to determine clinical Bhalla scores. Results The training, test, and external data sets comprised 82 patients with CF (mean age, 21 years ± 11 [SD]; 42 male), 28 patients (mean age, 18 years ± 11; 16 male), and 46 patients (mean age, 20 years ± 11; 24 male), respectively. In the test data set, the contrast-to-noise ratio of synthetic CT images (median, 303 [IQR, 221-382]) was higher than that of UTE MRI scans (median, 9.3 [IQR, 6.6-35]; P < .001). The median signal-to-noise ratio was similar between synthetic and real CT (88 [IQR, 84-92] vs 88 [IQR, 86-91]; P = .96). Synthetic CT had a lower noise level than real CT (median score, 26 [IQR, 22-30] vs 42 [IQR, 32-50]; P < .001) and the lowest level of artifacts (median score, 0 [IQR, 0-0]; P < .001). The concordance between Bhalla scores for synthetic and real CT images was almost perfect (intraclass correlation coefficient, ≥0.92). Conclusion Synthetic CT images showed almost perfect concordance with real CT images for the depiction of CF-related pulmonary alterations and had better image quality than UTE MRI. Clinical trial registration no. NCT03357562 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Schiebler and Glide-Hurst in this issue.
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Affiliation(s)
- Arthur Longuefosse
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Julien Raoult
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Ilyes Benlala
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Baudouin Denis de Senneville
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Thomas Benkert
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Julie Macey
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Stéphanie Bui
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Patrick Berger
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Gilbert Ferretti
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Jean-Yves Gaubert
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Renan Liberge
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Antoine Hutt
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Baptiste Morel
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - François Laurent
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Fabien Baldacci
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
| | - Gaël Dournes
- From the Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, Université Bordeaux Segalen, LaBRI, Mathematical Institute of Bordeaux (IMB), 146 rue Léo Saignat, 33076 Bordeaux, France (A.L., I.B., B.D.d.S., P.B., F.L., F.B., G.D.); CNRS, Bordeaux INP, LaBRI, UMR 5800, Bordeaux INP, UMR 5251, Talence, France (A.L., B.D.d.S., F.B.); CHU de Bordeaux, Service d'Imagerie Cardiovasculaire et Thoracique, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Centre de référence pédiatrique de la mucoviscidose, CIC 1401, Pessac, France (J.R., I.B., J.M., S.B., P.B., F.L., G.D.); INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France (I.B., P.B., F.L., G.D.); MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany (T.B.); Department of Radiology, Grenoble-Alpes University Hospital, Grenoble, France (G.F.); Imaging Department, Hôpital La Timone, APHM, Aix Marseille University, Marseille, France (J.Y.G.); Department of Radiology, CHU Nantes, Nantes, France (R.L.); Department of Thoracic Imaging, Heart & Lung Institute, Lille, France (A.H.); and Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, Tours, France (B.M.)
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Klaar R, Rabe M, Gaass T, Schneider MJ, Benlala I, Eze C, Corradini S, Belka C, Landry G, Kurz C, Dinkel J. Ventilation and perfusion MRI at a 0.35 T MR-Linac: feasibility and reproducibility study. Radiat Oncol 2023; 18:58. [PMID: 37013541 PMCID: PMC10069152 DOI: 10.1186/s13014-023-02244-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/07/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Hybrid devices that combine radiation therapy and MR-imaging have been introduced in the clinical routine for the treatment of lung cancer. This opened up not only possibilities in terms of accurate tumor tracking, dose delivery and adapted treatment planning, but also functional lung imaging. The aim of this study was to show the feasibility of Non-uniform Fourier Decomposition (NuFD) MRI at a 0.35 T MR-Linac as a potential treatment response assessment tool, and propose two signal normalization strategies for enhancing the reproducibility of the results. METHODS Ten healthy volunteers (median age 28 ± 8 years, five female, five male) were repeatedly scanned at a 0.35 T MR-Linac using an optimized 2D+t balanced steady-state free precession (bSSFP) sequence for two coronal slice positions. Image series were acquired in normal free breathing with breaks inside and outside the scanner as well as deep and shallow breathing. Ventilation- and perfusion-weighted maps were generated for each image series using NuFD. For intra-volunteer ventilation map reproducibility, a normalization factor was defined based on the linear correlation of the ventilation signal and diaphragm position of each scan as well as the diaphragm motion amplitude of a reference scan. This allowed for the correction of signal dependency on the diaphragm motion amplitude, which varies with breathing patterns. The second strategy, which can be used for ventilation and perfusion, eliminates the dependency on the signal amplitude by normalizing the ventilation/perfusion maps with the average ventilation/perfusion signal within a selected region-of-interest (ROI). The position and size dependency of this ROI was analyzed. To evaluate the performance of both approaches, the normalized ventilation/perfusion-weighted maps were compared and the deviation of the mean ventilation/perfusion signal from the reference was calculated for each scan. Wilcoxon signed-rank tests were performed to test whether the normalization methods can significantly improve the reproducibility of the ventilation/perfusion maps. RESULTS The ventilation- and perfusion-weighted maps generated with the NuFD algorithm demonstrated a mostly homogenous distribution of signal intensity as expected for healthy volunteers regardless of the breathing maneuver and slice position. Evaluation of the ROI's size and position dependency showed small differences in the performance. Applying both normalization strategies improved the reproducibility of the ventilation by reducing the median deviation of all scans to 9.1%, 5.7% and 8.6% for the diaphragm-based, the best and worst performing ROI-based normalization, respectively, compared to 29.5% for the non-normalized scans. The significance of this improvement was confirmed by the Wilcoxon signed rank test with [Formula: see text] at [Formula: see text]. A comparison of the techniques against each other revealed a significant difference in the performance between best ROI-based normalization and worst ROI ([Formula: see text]) and between best ROI-based normalization and scaling factor ([Formula: see text]), but not between scaling factor and worst ROI ([Formula: see text]). Using the ROI-based approach for the perfusion-maps, the uncorrected deviation of 10.2% was reduced to 5.3%, which was shown to be significant ([Formula: see text]). CONCLUSIONS Using NuFD for non-contrast enhanced functional lung MRI at a 0.35 T MR-Linac is feasible and produces plausible ventilation- and perfusion-weighted maps for volunteers without history of chronic pulmonary diseases utilizing different breathing patterns. The reproducibility of the results in repeated scans significantly benefits from the introduction of the two normalization strategies, making NuFD a potential candidate for fast and robust early treatment response assessment of lung cancer patients during MR-guided radiotherapy.
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Affiliation(s)
- Rabea Klaar
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Moritz Rabe
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Gaass
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Moritz J. Schneider
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Antaros Medical AB, BioVenture Hub, Mölndal, Sweden
| | - Ilyes Benlala
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, F-33600 Pessac, France
- CHU Bordeaux, Service d’Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d’Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France
- INSERM, U1045, Centre de Recherche Cardio-thoracique de Bordeaux, F-33600 Pessac, France
| | - Chukwuka Eze
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Munich, Germany
| | - Guillaume Landry
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Christopher Kurz
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Julien Dinkel
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
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8
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Dournes G, Benlala I, Laurent F. Airway wall thickness in severe and nonsevere asthma: is there a difference? Pol Arch Intern Med 2022; 132. [PMID: 35352544 DOI: 10.20452/pamw.16225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Gaël Dournes
- University of Bordeaux, INSERM, Cardio-Thoracic Research Center, Bordeaux, France; Department of Cardio-Thoracic Imaging, University Hospital of Bordeaux, Pessac, France.
| | - Ilyes Benlala
- University of Bordeaux, INSERM, Cardio-Thoracic Research Center, Bordeaux, France
- Department of Cardio-Thoracic Imaging, University Hospital of Bordeaux, Pessac, France
| | - François Laurent
- University of Bordeaux, INSERM, Cardio-Thoracic Research Center, Bordeaux, France
- Department of Cardio-Thoracic Imaging, University Hospital of Bordeaux, Pessac, France
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9
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Benlala I, De Senneville BD, Dournes G, Menant M, Gramond C, Thaon I, Clin B, Brochard P, Gislard A, Andujar P, Chammings S, Gallet J, Lacourt A, Delva F, Paris C, Ferretti G, Pairon JC, Laurent F. Deep Learning for the Automatic Quantification of Pleural Plaques in Asbestos-Exposed Subjects. Int J Environ Res Public Health 2022; 19:ijerph19031417. [PMID: 35162440 PMCID: PMC8835296 DOI: 10.3390/ijerph19031417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 12/10/2022]
Abstract
Objective: This study aimed to develop and validate an automated artificial intelligence (AI)-driven quantification of pleural plaques in a population of retired workers previously occupationally exposed to asbestos. Methods: CT scans of former workers previously occupationally exposed to asbestos who participated in the multicenter APEXS (Asbestos PostExposure Survey) study were collected retrospectively between 2010 and 2017 during the second and the third rounds of the survey. A hundred and forty-one participants with pleural plaques identified by expert radiologists at the 2nd and the 3rd CT screenings were included. Maximum Intensity Projection (MIP) with 5 mm thickness was used to reduce the number of CT slices for manual delineation. A Deep Learning AI algorithm using 2D-convolutional neural networks was trained with 8280 images from 138 CT scans of 69 participants for the semantic labeling of Pleural Plaques (PP). In all, 2160 CT images from 36 CT scans of 18 participants were used for AI testing versus ground-truth labels (GT). The clinical validity of the method was evaluated longitudinally in 54 participants with pleural plaques. Results: The concordance correlation coefficient (CCC) between AI-driven and GT was almost perfect (>0.98) for the volume extent of both PP and calcified PP. The 2D pixel similarity overlap of AI versus GT was good (DICE = 0.63) for PP, whether they were calcified or not, and very good (DICE = 0.82) for calcified PP. A longitudinal comparison of the volumetric extent of PP showed a significant increase in PP volumes (p < 0.001) between the 2nd and the 3rd CT screenings with an average delay of 5 years. Conclusions: AI allows a fully automated volumetric quantification of pleural plaques showing volumetric progression of PP over a five-year period. The reproducible PP volume evaluation may enable further investigations for the comprehension of the unclear relationships between pleural plaques and both respiratory function and occurrence of thoracic malignancy.
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Affiliation(s)
- Ilyes Benlala
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
- Correspondence:
| | - Baudouin Denis De Senneville
- Mathematical Institute of Bordeaux (IMB), CNRS, INRIA, Bordeaux INP, UMR 5251, Université de Bordeaux, 33400 Talence, France;
| | - Gael Dournes
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
| | - Morgane Menant
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Celine Gramond
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Isabelle Thaon
- Centre de Consultation de Pathologies Professionnelles, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France;
| | - Bénédicte Clin
- Service de Santé au Travail et Pathologie Professionnelle, CHU Caen, 14000 Caen, France;
- Faculté de Médecine, Université de Caen, 14000 Caen, France
| | - Patrick Brochard
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service de Médecine du Travail et de Pathologies Professionnelles, CHU de Bordeaux, 33000 Bordeaux, France
| | - Antoine Gislard
- Faculté de Médecine, Normandie Université, UNIROUEN, UNICAEN, ABTE, 76000 Rouen, France;
- Centre de Consultations de Pathologie Professionnelle, CHU de Rouen, CEDEX, 76031 Rouen, France
| | - Pascal Andujar
- Equipe GEIC20, INSERM U955, 94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, 94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, 94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - Soizick Chammings
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - Justine Gallet
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Aude Lacourt
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Fleur Delva
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Christophe Paris
- Service de Santé au Travail et Pathologie Professionnelle, CHU Rennes, 35000 Rennes, France;
- Institut de Recherche en Santé, Environnement et Travail, INSERM U1085, 35000 Rennes, France
| | - Gilbert Ferretti
- INSERM U 1209 IAB, 38700 La Tronche, France;
- Domaine de la Merci, Faculté de Médecine, Université Grenoble Alpes, 38706 La Tronche, France
- Service de Radiologie Diagnostique et Interventionnelle Nord, CHU Grenoble Alpes, CS 10217, 38043 Grenoble, France
| | - Jean-Claude Pairon
- Equipe GEIC20, INSERM U955, 94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, 94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, 94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - François Laurent
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
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10
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Dournes G, Benlala I, Laurent F. Contrast-enhanced Magnetic Resonance Imaging Does Not Detect a Progression in Lung Morphological Score in Preschool Children with Cystic Fibrosis. Am J Respir Crit Care Med 2022; 205:134. [PMID: 34731588 PMCID: PMC8865590 DOI: 10.1164/rccm.202107-1747le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gaël Dournes
- University Bordeaux Bordeaux, France.,University Hospital Center of Bordeaux Pessac, France
| | - Ilyes Benlala
- University Bordeaux Bordeaux, France.,University Hospital Center of Bordeaux Pessac, France
| | - François Laurent
- University Bordeaux Bordeaux, France.,University Hospital Center of Bordeaux Pessac, France
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11
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Dournes G, Benlala I, Laurent F. Expanding the Clinical Application of Lung MRI: With or without Ultrashort Echo Time or Zero Echo Time? Radiology 2021; 301:E412. [PMID: 34402670 DOI: 10.1148/radiol.2021210020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gaël Dournes
- Centre de Recherche Cardio-thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France.,Service d'Imagerie Thoracique et Cardiovasculaire, CHU de Bordeaux, Pessac, France
| | - Ilyes Benlala
- Centre de Recherche Cardio-thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France.,Service d'Imagerie Thoracique et Cardiovasculaire, CHU de Bordeaux, Pessac, France
| | - François Laurent
- Centre de Recherche Cardio-thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France.,Service d'Imagerie Thoracique et Cardiovasculaire, CHU de Bordeaux, Pessac, France
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12
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Laurent F, Benlala I, Dournes G, Gramond C, Thaon I, Clin B, Brochard P, Gislard A, Andujar P, Chammings S, Gallet J, Lacourt A, Delva F, Paris C, Ferretti G, Pairon JC. Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age. J Clin Med 2021; 10:jcm10143130. [PMID: 34300298 PMCID: PMC8307087 DOI: 10.3390/jcm10143130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/05/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: the aim of this study was to evaluate the association between interstitial lung abnormalities, asbestos exposure and age in a population of retired workers previously occupationally exposed to asbestos. Methods: previously occupationally exposed former workers to asbestos eligible for a survey conducted between 2003 and 2005 in four regions of France, underwent chest CT examinations and pulmonary function testing. Industrial hygienists evaluated asbestos exposure and calculated for each subject a cumulative exposure index (CEI) to asbestos. Smoking status information was also collected in this second round of screening. Expert radiologists performed blinded independent double reading of chest CT-scans and classified interstitial lung abnormalities into: no abnormality, minor interstitial findings, interstitial findings inconsistent with UIP, possible or definite UIP. In addition, emphysema was assessed visually (none, minor: emphysema <25%, moderate: between 25 and 50% and severe: >50% of the lung). Logistic regression models adjusted for age and smoking were used to assess the relationship between interstitial lung abnormalities and occupational asbestos exposure. Results: the study population consisted of 2157 male subjects. Interstitial lung abnormalities were present in 365 (16.7%) and emphysema in 444 (20.4%). Significant positive association was found between definite or possible UIP pattern and age (OR adjusted =1.08 (95% CI: 1.02–1.13)). No association was found between interstitial abnormalities and CEI or the level of asbestos exposure. Conclusion: presence of interstitial abnormalities at HRCT was associated to aging but not to cumulative exposure index in this cohort of former workers previously occupationally exposed to asbestos.
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Affiliation(s)
- François Laurent
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, F-33000 Bordeaux, France
- Correspondence: ; Tel.: +33-5-2454-9136
| | - Ilyes Benlala
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, F-33000 Bordeaux, France
| | - Gael Dournes
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, F-33000 Bordeaux, France
| | - Celine Gramond
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Isabelle Thaon
- Centre de Consultation de Pathologies Professionnelles, CHRU de Nancy, Université de Lorraine, F-54000 Nancy, France;
| | - Bénédicte Clin
- Service de Santé au Travail et Pathologie Professionnelle, CHU Caen, F-14000 Caen, France;
- Faculté de Médecine, Université de Caen, ANTICIPE, INSERM U1086, F-14000 Caen, France
| | - Patrick Brochard
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service de Médecine du Travail et de Pathologies Professionnelles, CHU de Bordeaux, F-33000 Bordeaux, France
| | - Antoine Gislard
- Centre de Consultations de Pathologie Professionnelle, UNIROUEN, UNICAEN, ABTE, F-76000 Rouen, France;
- CHU de Rouen, Normandie Université, F-76031 Rouen, France
| | - Pascal Andujar
- Equipe GEIC20, INSERM U955, F-94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, F-94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, F-94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, F-94000 Créteil, France;
| | - Soizick Chammings
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, F-94000 Créteil, France;
| | - Justine Gallet
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Aude Lacourt
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Fleur Delva
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Christophe Paris
- Service de Santé au Travail et Pathologie Professionnelle, CHU Rennes, F-35000 Rennes, France;
- Institut de Recherche en Santé, Environnement et Travail, INSERM U1085, F-35000 Rennes, France
| | - Gilbert Ferretti
- INSERM U 1209 IAB, F-38700 La Tronche, France;
- Domaine de la Merci, Université Grenoble Alpes, F-38706 La Tronche, France
- Service de Radiologie Diagnostique et Interventionnelle Nord, CHU Grenoble Alpes, CS 10217, F-38043 Grenoble, France
| | - Jean-Claude Pairon
- Equipe GEIC20, INSERM U955, F-94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, F-94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, F-94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, F-94000 Créteil, France;
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Dournes G, Hall CS, Willmering MM, Brody AS, Macey J, Bui S, Denis-De-Senneville B, Berger P, Laurent F, Benlala I, Woods JC. Artificial intelligence in CT for quantifying lung changes in the era of CFTR modulators. Eur Respir J 2021; 59:13993003.00844-2021. [PMID: 34266943 DOI: 10.1183/13993003.00844-2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/02/2021] [Indexed: 11/05/2022]
Abstract
RATIONALE Chest computed tomography (CT) remains the imaging standard for demonstrating cystic fibrosis airway structural disease in vivo. However, visual scorings as an outcome measure are time-consuming, require training, and lack high reproducibility. OBJECTIVE To validate a fully automated artificial intelligence-driven scoring of cystic fibrosis lung disease severity. METHODS Data were retrospectively collected in three cystic fibrosis reference centers, between 2008 and 2020, in 184 patients 4 to 54-years-old. An algorithm using three two-dimensional convolutional neural networks was trained with 78 patients' CTs (23 530 CT slices) for the semantic labeling of bronchiectasis, peribronchial thickening, bronchial mucus, bronchiolar mucus, and collapse/consolidation. 36 patients' CTs (11 435 CT slices) were used for testing versus ground-truth labels. The method's clinical validity was assessed in an independent group of 70 patients with or without lumacaftor/ivacaftor treatment (n=10 and 60, respectively) with repeat examinations. Similarity and reproducibility were assessed using Dice coefficient, correlations using Spearman test, and paired comparisons using Wilcoxon rank test. MEASUREMENT AND MAIN RESULTS The overall pixelwise similarity of artificial intelligence-driven versus ground-truth labels was good (Dice coefficient=0.71). All artificial intelligence-driven volumetric quantifications had moderate to very good correlations to a visual imaging scoring (p<0.001) and fair to good correlations to FEV1% at pulmonary function test (p<0.001). Significant decreases in peribronchial thickening (p=0.005), bronchial mucus (p=0.005), bronchiolar mucus (p=0.007) volumes were measured in patients with lumacaftor/ivacaftor. Conversely, bronchiectasis (p=0.002) and peribronchial thickening (p=0.008) volumes increased in patients without lumacaftor/ivacaftor. The reproducibility was almost perfect (Dice>0.99). CONCLUSION Artificial intelligence allows a fully automated volumetric quantification of cystic fibrosis-related modifications over an entire lung. The novel scoring system could provide a robust disease outcome in the era of effective CFTR modulator therapy.
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Affiliation(s)
- Gael Dournes
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France .,CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France.,Indicates that both authors contributed the same to the study
| | - Chase S Hall
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, Kansas, United States of America.,Indicates that both authors contributed the same to the study
| | - Matthew M Willmering
- Division of Pulmonary Medicine and Department of Radiology, Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Alan S Brody
- Division of Pulmonary Medicine and Department of Radiology, Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Julie Macey
- CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Stephanie Bui
- Bordeaux University Hospital, Hôpital Pellegrin-Enfants, paediatric Cystic Fibrosis Reference Center (CRCM), Centre d'Investigation Clinique (CIC 1401), Bordeaux, France
| | | | - Patrick Berger
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France.,CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - François Laurent
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France.,CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Ilyes Benlala
- Univ. Bordeaux, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France.,CHU Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Jason C Woods
- Division of Pulmonary Medicine and Department of Radiology, Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States of America
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14
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Benlala I, Dournes G, Girodet PO, Benkert T, Laurent F, Berger P. Evaluation of bronchial wall thickness in asthma using magnetic resonance imaging. Eur Respir J 2021; 59:13993003.00329-2021. [PMID: 34049945 DOI: 10.1183/13993003.00329-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/20/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Bronchial thickening is a pathological feature of asthma that has been evaluated using computed tomography (CT), an ionised radiation technique. Magnetic Resonance Imaging (MRI) with Ultrashort Echo Time (UTE) pulse sequences could be an alternative to CT. OBJECTIVES To measure bronchial dimensions using MRI-UTE in asthmatic patients, by evaluating the accuracy and agreement with CT, by comparing severe and non-severe asthma and by correlating with pulmonary function tests. METHODS We assessed bronchial dimensions (wall area (WA), lumen area (LA), normalised wall area (WA%), and wall thickness (WT)) by MRI-UTE and CT in 15 non-severe and 15 age- and sex-matched severe asthmatic patients (NCT03089346). Accuracy and agreement between MRI and CT was evaluated by paired t-tests and Bland-Altman analysis. Reproducibility was assessed by intra-class correlation coefficient and Bland-Altman analysis. Comparison between non-severe and severe asthmatic parameters was performed by Student-t, Mann-Whitney or Fisher's Exact tests. Correlations were assessed by Pearson or Spearman coefficients. RESULTS LA, WA%, and WT were not significantly different between MRI-UTE and CT, with good correlations and concordance. Inter- and intra-observer reproducibility was moderate to good. WA% and WT were both higher in severe than in non-severe asthmatic patients. WA, WA% and WT were all negatively correlated with FEV1. CONCLUSION We demonstrated that MRI-UTE is an accurate and reliable radiation-free method to assess bronchial wall dimensions in asthma, with enough spatial resolution to differentiate severe from non-severe asthma.
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Affiliation(s)
- Ilyes Benlala
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Bordeaux, France.,CHU Bordeaux, Service de Radiologie et d'imagerie diagnostique et interventionnelle, CIC-P 1401, Service d'Exploration Fonctionnelle Respiratoire, Bordeaux, France.,INSERM, Centre de Recherche Cardio-thoracique de Bordeaux (U1045), Centre d'Investigation Clinique (CIC-P 1401), Bordeaux, France
| | - Gaël Dournes
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Bordeaux, France.,CHU Bordeaux, Service de Radiologie et d'imagerie diagnostique et interventionnelle, CIC-P 1401, Service d'Exploration Fonctionnelle Respiratoire, Bordeaux, France.,INSERM, Centre de Recherche Cardio-thoracique de Bordeaux (U1045), Centre d'Investigation Clinique (CIC-P 1401), Bordeaux, France
| | - Pierre-Olivier Girodet
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Bordeaux, France.,CHU Bordeaux, Service de Radiologie et d'imagerie diagnostique et interventionnelle, CIC-P 1401, Service d'Exploration Fonctionnelle Respiratoire, Bordeaux, France.,INSERM, Centre de Recherche Cardio-thoracique de Bordeaux (U1045), Centre d'Investigation Clinique (CIC-P 1401), Bordeaux, France
| | - Thomas Benkert
- MR application predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - François Laurent
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Bordeaux, France.,CHU Bordeaux, Service de Radiologie et d'imagerie diagnostique et interventionnelle, CIC-P 1401, Service d'Exploration Fonctionnelle Respiratoire, Bordeaux, France.,INSERM, Centre de Recherche Cardio-thoracique de Bordeaux (U1045), Centre d'Investigation Clinique (CIC-P 1401), Bordeaux, France
| | - Patrick Berger
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, Bordeaux, France .,CHU Bordeaux, Service de Radiologie et d'imagerie diagnostique et interventionnelle, CIC-P 1401, Service d'Exploration Fonctionnelle Respiratoire, Bordeaux, France.,INSERM, Centre de Recherche Cardio-thoracique de Bordeaux (U1045), Centre d'Investigation Clinique (CIC-P 1401), Bordeaux, France
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Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. It is a heterogeneous disease involving different components of the lung to varying extents. Developments in medical imaging and image analysis techniques provide new insights in the assessment of the structural and functional changes of the disease. This article reviews the leading imaging techniques: CT and MRI of the lung in research settings and clinical routine. Both visual and quantitative methods are reviewed, emphasizing their relevance to patient phenotyping and outcome prediction.
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Affiliation(s)
- Ilyes Benlala
- Centre de recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, INSERM, Bordeaux, France
| | - François Laurent
- Centre de recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, INSERM, Bordeaux, France
| | - Gael Dournes
- Centre de recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, INSERM, Bordeaux, France
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16
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Dournes G, Walkup LL, Benlala I, Willmering MM, Macey J, Bui S, Laurent F, Woods JC. The Clinical Use of Lung MRI in Cystic Fibrosis: What, Now, How? Chest 2020; 159:2205-2217. [PMID: 33345950 PMCID: PMC8579315 DOI: 10.1016/j.chest.2020.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/24/2020] [Accepted: 12/03/2020] [Indexed: 12/19/2022] Open
Abstract
To assess airway and lung parenchymal damage noninvasively in cystic fibrosis (CF), chest MRI has been historically out of the scope of routine clinical imaging because of technical difficulties such as low proton density and respiratory and cardiac motion. However, technological breakthroughs have emerged that dramatically improve lung MRI quality (including signal-to-noise ratio, resolution, speed, and contrast). At the same time, novel treatments have changed the landscape of CF clinical care. In this contemporary context, there is now consensus that lung MRI can be used clinically to assess CF in a radiation-free manner and to enable quantification of lung disease severity. MRI can now achieve three-dimensional, high-resolution morphologic imaging, and beyond this morphologic information, MRI may offer the ability to sensitively differentiate active inflammation vs scarring tissue. MRI could also characterize various forms of inflammation for early guidance of treatment. Moreover, functional information from MRI can be used to assess regional, small-airway disease with sensitivity to detect small changes even in patients with mild CF. Finally, automated quantification methods have emerged to support conventional visual analyses for more objective and reproducible assessment of disease severity. This article aims to review the most recent developments of lung MRI, with a focus on practical application and clinical value in CF, and the perspectives on how these modern techniques may converge and impact patient care soon.
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Affiliation(s)
- Gaël Dournes
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France; Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Ilyes Benlala
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Julie Macey
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Stephanie Bui
- CHU Bordeaux, Hôpital Pellegrin-Enfants, Pediatric Cystic Fibrosis Reference Center (CRCM), Centre d'Investigation Clinique (CIC 1401), Bordeaux, France
| | - François Laurent
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
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Benlala I, Albat A, Blanchard E, Macey J, Raherison C, Benkert T, Berger P, Laurent F, Dournes G. Quantification of MRI T2 Interstitial Lung Disease Signal-Intensity Volume in Idiopathic Pulmonary Fibrosis: A Pilot Study. J Magn Reson Imaging 2020; 53:1500-1507. [PMID: 33241628 DOI: 10.1002/jmri.27454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Imaging has played a pivotal role in the diagnosis of idiopathic pulmonary fibrosis (IPF). Recent reports suggest that T2 -weighted MRI could be sensitive to monitor signal-intensity modifications of the lung parenchyma, which may relate to the disease activity in IPF. However, there is a lack of automated tools to reproducibly quantify the extent of the disease, especially using MRI. PURPOSE To assess the feasibility of T2 interstitial lung disease signal-intensity volume quantification using a semiautomated method in IPF. STUDY TYPE Single center, retrospective. POPULATION A total of 21 adult IPF patients and four control subjects without lung interstitial abnormalities. FIELD STRENGTH/SEQUENCE Both free-breathing ultrashort echo time (TE) lung MRI using the spiral volume interpolated breath hold examination (VIBE) sequence (3D-UTE) and T2 -BLADE at 1.5T. ASSESSMENT Semiautomated segmentation of the lung volume was done using 3D-UTE and registered to the T2 -BLADE images. The interstitial lung disease signal-intensity volume (ISIV) was quantified using a Gaussian mixture model clustering and then normalized to the lung volume to calculate T2 -ISIV. The composite physiological index (CPI) and forced vital capacity (FVC) were measured as known biomarkers of IPF severity. Measurements were performed independently by three readers and averaged. The reproducibility between measurements was also assessed. STATISTICAL TESTS Reproducibility was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. Correlations were assessed using Spearman test. Comparison of median was assessed using the Mann-Whitney test. RESULTS The reproducibility of T2 -ISIV was high, with ICCs = 0.99. Using Bland-Altman analysis, the mean differences were found between -0.8 to 0.1. T2 -ISIV significantly correlated with CPI and FVC (rho = 0.48 and 0.50, respectively; P < 0.05). T2 -ISIV was significantly higher in IPF than in controls (P < 0.05). DATA CONCLUSION T2 -ISIV appears to be able to reproducibly assess the volumetric extent of abnormal interstitial lung signal-intensity modifications in patients with IPF, and correlate with disease severity. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Ilyes Benlala
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, INSERM U1045, CIC 1401, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Agnes Albat
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Elodie Blanchard
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Julie Macey
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, INSERM U1045, CIC 1401, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Chantal Raherison
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France.,Bordeaux Population Health Research Center, Univ. Bordeaux, INSERM, Team EPICENE, UMR 1219, Bordeaux, France
| | - Thomas Benkert
- Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Patrick Berger
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, INSERM U1045, CIC 1401, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - François Laurent
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, INSERM U1045, CIC 1401, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
| | - Gaël Dournes
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, INSERM U1045, CIC 1401, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, Pessac, France
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Benlala I, Hocke F, Macey J, Bui S, Berger P, Laurent F, Dournes G. Quantification of MRI T2-weighted High Signal Volume in Cystic Fibrosis: A Pilot Study. Radiology 2019; 294:186-196. [PMID: 31660805 DOI: 10.1148/radiol.2019190797] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background In patients with cystic fibrosis (CF), pulmonary structures with high MRI T2 signal intensity relate to inflammatory changes in the lung and bronchi. These areas of pathologic abnormalities can serve as imaging biomarkers. The feasibility of automated quantification is unknown. Purpose To quantify the MRI T2 high-signal-intensity lung volume and T2-weighted volume-intensity product (VIP) by using a black-blood T2-weighted radial fast spin-echo sequence in participants with CF. Materials and Methods Healthy individuals and study participants with CF were prospectively enrolled between January 2017 and November 2017. All participants underwent a lung MRI protocol including T2-weighted radial fast spin-echo sequence. Participants with CF also underwent pulmonary function tests the same day. Participants with CF exacerbation underwent repeat MRI after their treatment with antibiotics. Two observers supervised automated quantification of T2-weighted high-signal-intensity volume (HSV) and T2-weighted VIP independently, and the average score was chosen as consensus. Statistical analysis used the Mann-Whitney test for comparison of medians, correlations used the Spearman test, comparison of paired medians used the Wilcoxon signed rank test, and reproducibility was evaluated by using intraclass correlation coefficient. Results In 10 healthy study participants (median age, 21 years [age range, 18-27 years]; six men) and 12 participants with CF (median age, 18 years [age range, 9-40 years]; eight men), T2-weighted HSV was equal to 0% and 4.1% (range, 0.1%-17%), respectively, and T2-weighted VIP was equal to 0 msec and 303 msec (range, 39-1012 msec), respectively (P < .001). In participants with CF, T2-weighted HSV or T2-weighted VIP were associated with forced expiratory volume in 1 second percentage predicted (ρ = -0.88 and ρ = -0.94, respectively; P < .001). In six participants with CF exacerbation and follow-up after treatment, a decrease in both T2-weighted HSV and T2-weighted VIP was observed (P = .03). The intra- and interobserver reproducibility of MRI were good (intraclass correlation coefficients, >0.99 and >0.99, respectively). Conclusion In patients with cystic fibrosis (CF), automated quantification of lung MRI high-signal-intensity volume was reproducible and correlated with pulmonary function testing severity, and it improved after treatment for CF exacerbation. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Revel and Chassagnon in this issue.
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Affiliation(s)
- Ilyes Benlala
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - François Hocke
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Julie Macey
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Stéphanie Bui
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Patrick Berger
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - François Laurent
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Gaël Dournes
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
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Coste F, Benlala I, Dournes G, Girodet PO, Laurent F, Berger P. Assessing pulmonary hypertension in COPD. Is there a role for computed tomography? Int J Chron Obstruct Pulmon Dis 2019; 14:2065-2079. [PMID: 31564854 PMCID: PMC6732516 DOI: 10.2147/copd.s207363] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/10/2019] [Indexed: 12/22/2022] Open
Abstract
Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD) and is associated with increased morbidity and mortality. Reference standard method to diagnose PH is right heart catheterization. Several non-invasive imaging techniques have been employed in the detection of PH. Among them, computed tomography (CT) is the most commonly used for phenotyping and detecting complications of COPD. Several CT findings have also been described in patients with severe PH. Nevertheless, CT analysis is currently based on visual findings which can lead to reproducibility failure. Therefore, there is a need for quantification in order to assess objective criteria. In this review, progresses in automated analyses of CT parameters and their values in predicting PH and COPD outcomes are presented.
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Affiliation(s)
- Florence Coste
- University Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, F-33000 France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC1401, Bordeaux, F-33000 France
| | - Ilyes Benlala
- University Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, F-33000 France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC1401, Bordeaux, F-33000 France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, Pessac, F-33600 France
| | - Gaël Dournes
- University Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, F-33000 France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC1401, Bordeaux, F-33000 France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, Pessac, F-33600 France
| | - Pierre-Olivier Girodet
- University Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, F-33000 France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC1401, Bordeaux, F-33000 France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, Pessac, F-33600 France
| | - François Laurent
- University Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, F-33000 France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC1401, Bordeaux, F-33000 France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, Pessac, F-33600 France
| | - Patrick Berger
- University Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, F-33000 France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC1401, Bordeaux, F-33000 France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, Pessac, F-33600 France
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Benlala I, Berger P, Girodet PO, Dromer C, Macey J, Laurent F, Dournes G. Automated Volumetric Quantification of Emphysema Severity by Using Ultrashort Echo Time MRI: Validation in Participants with Chronic Obstructive Pulmonary Disease. Radiology 2019; 292:216-225. [DOI: 10.1148/radiol.2019190052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Coste F, Benlala I, Dournes G, Dromer C, Blanchard E, Girodet PO, Montaudon M, Baldacci F, Picard F, Marthan R, Laurent F, Berger P. Quantitative CT assessment of bronchial and vascular alterations in severe precapillary pulmonary hypertension. Int J Chron Obstruct Pulmon Dis 2019; 14:381-389. [PMID: 30809092 PMCID: PMC6377046 DOI: 10.2147/copd.s177638] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Little is known about in vivo alterations at bronchial and vascular levels in severe pulmonary hypertension (PH) of different etiologies. We aimed to compare quantitative computed tomography (CT) data from the following three groups of severe precapillary PH patients: COPD, idiopathic pulmonary arterial hypertension (iPAH), and chronic thromboembolic PH (CTEPH). Patients and methods This study was approved by the institutional review board. Severe PH patients (mean pulmonary arterial pressure [mPAP] ≥35 mmHg) with COPD, iPAH, or CTEPH (n=24, 16, or 16, respectively) were included retrospectively between January 2008 and January 2017. Univariate analysis of mPAP was performed in each severe PH group. Bronchial wall thickness (WT) and percentage of cross sectional area of pulmonary vessels less than 5 mm2 normalized by lung area (%CSA<5) were measured and compared using CT, and then combined to arterial partial pressure of oxygen (PaO2) to generate a “paw score” compared within the three groups using Kruskal–Wallis and its sensitivity using Fisher’s exact test. Results WT was higher and %CSA<5 was lower in the COPD group compared to iPAH and CTEPH groups. Mosaic pattern was higher in CTEPH group than in others. In severe PH patients secondary to COPD, mPAP was positively correlated to %CSA<5. By contrast, in severe iPAH, this correlation was negative, or not correlated in severe CTEPH groups. In the COPD group, “paw score” showed higher sensitivity than in the other two groups. Conclusion Unlike in severe iPAH and CTEPH, severe PH with COPD can be predicted by “paw score” reflecting bronchial and vascular morphological differential alterations.
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Affiliation(s)
- Florence Coste
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France,
| | - Ilyes Benlala
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France,
| | - Gaël Dournes
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France, .,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - Claire Dromer
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - Elodie Blanchard
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - Pierre-Olivier Girodet
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France, .,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - Michel Montaudon
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France, .,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - Fabien Baldacci
- Université de Bordeaux, LaBRI, F-33405 Talence Cedex, France
| | - François Picard
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - Roger Marthan
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France, .,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - François Laurent
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France, .,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
| | - Patrick Berger
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, .,Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, CIC1401, F-33000 Bordeaux, France, .,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Cardiologie, CIC1401, Service d'Explorations Fonctionnelles Respiratoires, F-33600 Pessac, France
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Benlala I, Laurent F, Dournes G. T2-weighted PROPELLER MRI is not suitable for pulmonary emphysema quantification. ROFO-FORTSCHR RONTG 2018; 190:1169-1170. [DOI: 10.1055/a-0757-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ilyes Benlala
- Université de Bordeaux Collège Sciences de la Santé, Centre Hospitalier Universitaire de Bordeaux
| | - François Laurent
- Université de Bordeaux Collège Sciences de la Santé, Centre Hospitalier Universitaire de Bordeaux
| | - Gael Dournes
- Université de Bordeaux Collège Sciences de la Santé, Centre Hospitalier Universitaire de Bordeaux
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Dournes G, Yazbek J, Benhassen W, Benlala I, Blanchard E, Truchetet ME, Macey J, Berger P, Laurent F. 3D ultrashort echo time MRI of the lung using stack-of-spirals and spherical k-Space coverages: Evaluation in healthy volunteers and parenchymal diseases. J Magn Reson Imaging 2018; 48:1489-1497. [PMID: 30203889 DOI: 10.1002/jmri.26212] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/18/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Ultrashort echo time (UTE) has been shown to improve lung MRI quality in three dimensions. The evaluation of 3D-UTE stack-of-spirals VIBE (3D-USV) sequence for parenchymal diseases and a comparison of performance with that of a spherical mode of acquisition is needed. PURPOSE To assess MRI quality using a prototypical 3D-USV sequence and to compare performance with that of a spherical acquisition using Pointwise Encoding Time Reduction with Radial Acquisition (PETRA). STUDY TYPE Monocenter, prospective. POPULATION Twelve healthy volunteers and 32 adult patients with either cystic fibrosis (CF; n = 16) or interstitial lung disease (ILD; n = 16). FIELD STRENGTH/SEQUENCE Both free-breathing 3D-USV and PETRA were completed at 1.5T. ASSESSMENT In healthy volunteers, visual analysis of imaging quality was scored using a Likert scale. Quantitative evaluation of apparent signal ratio (Sr) and contrast ratio (Cr) was measured. Patients with CF and ILD completed both computed tomography (CT) and MRI. Depiction of structural alterations was assessed using dedicated clinical scores. All evaluations were done in consensus by two readers. STATISTICAL TESTS Comparison of means was assessed using the Wilcoxon signed rank test. Concordance and agreement between CT and MRI were assessed using the intraclass correlation coefficient (ICC) and kappa test. RESULTS In controls, 3D-USV yielded lower artifacts owing to better automatic respiratory synchronization than PETRA (P < 0.001). However, Sr and Cr of 3D-USV were found significantly lower by 2.25- and 2.36-fold, respectively (P < 0.001). In patients, 3D-USV and PETRA showed comparable performances to assess airway severity in CF (Bhalla score, ICC = 0.89 and ICC = 0.92, respectively) and presence of structural alterations in ILD such as honeycombing (kappa = 0.68 and kappa = 0.69, respectively). DATA CONCLUSION 3D-USV enables high-resolution morphological imaging of the lung without need of an external device to compensate respiratory motions. Automation and robustness of the method may facilitate clinical application for both airway and interstitial lung investigations. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;48:1489-1497.
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Affiliation(s)
- Gaël Dournes
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | - Joseph Yazbek
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | | | - Ilyes Benlala
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | - Elodie Blanchard
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | - Marie-Elise Truchetet
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | - Julie Macey
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | - Patrick Berger
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
| | - François Laurent
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.,CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service de Rhumatologie, Service d'Exploration Fonctionnelle Respiratoire, Pessac, France
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