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12.02.2016 | Chest

Diffusion weighted imaging in cystic fibrosis disease: beyond morphological imaging

verfasst von: Pierluigi Ciet, Goffredo Serra, Eleni Rosalina Andrinopoulou, Silvia Bertolo, Mirco Ros, Carlo Catalano, Stefano Colagrande, Harm A. W. M. Tiddens, Giovanni Morana

Erschienen in: European Radiology | Ausgabe 11/2016

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Abstract

Objectives

To explore the feasibility of diffusion-weighted imaging (DWI) to assess inflammatory lung changes in patients with Cystic Fibrosis (CF)

Methods

CF patients referred for their annual check-up had spirometry, chest-CT and MRI on the same day. MRI was performed in a 1.5 T scanner with BLADE and EPI-DWI sequences (b = 0–600 s/mm²). End-inspiratory and end-expiratory scans were acquired in multi-row scanners. DWI was scored with an established semi-quantitative scoring system. DWI score was correlated to CT sub-scores for bronchiectasis (CF-CT_BE), mucus (CF-CT_mucus), total score (CF-CT_total-score), FEV₁, and BMI. T-test was used to assess differences between patients with and without DWI-hotspots.

Results

Thirty-three CF patients were enrolled (mean 21 years, range 6–51, 19 female). 4 % (SD 2.6, range 1.5-12.9) of total CF-CT alterations presented DWI-hotspots. DWI-hotspots coincided with mucus plugging (60 %), consolidation (30 %) and bronchiectasis (10 %). DWI_total-score correlated (all p < 0.0001) positively to CF-CT_BE (r = 0.757), CF-CT_mucus (r = 0.759) and CF-CT_total-score (r = 0.79); and negatively to FEV₁ (r = 0.688). FEV₁ was significantly higher (p < 0.0001) in patients without DWI-hotspots.

Conclusions

DWI-hotspots strongly correlated with radiological and clinical parameters of lung disease severity. Future validation studies are needed to establish the exact nature of DWI-hotspots in CF patients.

Key Points

• DWI hotspots only partly overlapped structural abnormalities on morphological imaging

• DWI strongly correlated with radiological and clinical indicators of CF-disease severity

• Patients with more DWI hotspots had lower lung function values

• Mucus score best predicted the presence of DWI-hotspots with restricted diffusion.

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Tiddens HAWM, Donaldson SH, Rosenfeld M, Paré PD (2010) Cystic fibrosis lung disease starts in the small airways: can we treat it more effectively? Pediatr Pulmonol 45:107–117CrossRefPubMed

Loeve M, Gerbrands K, Hop WC et al (2011) Bronchiectasis and pulmonary exacerbations in children and young adults with cystic fibrosis. Chest 140:178–185CrossRefPubMed

Conway S, Balfour-Lynn IM, De Rijcke K et al (2014) European cystic fibrosis society standards of care: framework for the cystic fibrosis centre. J Cyst Fibros 13:S3–S22CrossRefPubMed

Grasemann H, Ratjen F (2013) Early lung disease in cystic fibrosis. Lancet Respir Med 1:148–157CrossRefPubMed

Eichinger M, Heussel C-P, Kauczor H-U et al (2010) Computed tomography and magnetic resonance imaging in cystic fibrosis lung disease. J Magn Reson Imaging 32:1370–1378CrossRefPubMed

Loeve M, Hop WCJ, De Bruijne M et al (2012) Chest computed tomography scores are predictive of survival in patients with cystic fibrosis awaiting lung transplantation. Am J Respir Crit Care Med 185:1096–1103CrossRefPubMed

Kuo W, Ciet P, Tiddens HAWM et al (2014) Monitoring cystic fibrosis lung disease by computed tomography. Radiation risk in perspective. Am J Respir Crit Care Med 189:1328–1336CrossRefPubMed

Wielpütz MO, Eichinger M, Puderbach M (2013) Magnetic resonance imaging of cystic fibrosis lung disease. J Thorac Imaging 28:151–159CrossRefPubMed

Failo R, Wielopolski PA, Tiddens HAWM et al (2009) Lung morphology assessment using MRI: a robust ultra-short TR/TE 2D steady state free precession sequence used in cystic fibrosis patients. Magn Reson Med 61:299–306CrossRefPubMed

10.

Ciet P, Serra G, Bertolo S et al (2015) Assessment of CF lung disease using motion corrected PROPELLER MRI: a comparison with CT. Eur Radiol. doi:10.1007/s00330-015-3850-9 PubMed

11.

Ma W, Sheikh K, Svenningsen S et al (2015) Ultra-short echo-time pulmonary MRI: Evaluation and reproducibility in COPD subjects with and without bronchiectasis. J Magn Reson Imaging 41:1465–1474CrossRefPubMed

12.

Dournes G, Grodzki D, Macey J et al (2015) Quiet submillimeter MR imaging of the lung is feasible with a PETRA sequence at 1.5 T. Radiology 276:258–265CrossRefPubMed

13.

Tiddens HAWM, Stick SM, Wild JM et al (2015) Respiratory tract exacerbations revisited: ventilation, inflammation, perfusion, and structure (VIPS) monitoring to redefine treatment. Pediatr Pulmonol 50:S57–S65CrossRefPubMed

14.

Bauman G, Puderbach M, Heimann T et al (2013) Validation of fourier decomposition MRI with dynamic contrast-enhanced MRI using visual and automated scoring of pulmonary perfusion in young cystic fibrosis patients. Eur J Radiol 82:2371–2377CrossRefPubMed

15.

van Beek EJR, Hill C, Woodhouse N et al (2007) Assessment of lung disease in children with cystic fibrosis using hyperpolarized 3-Helium MRI: comparison with shwachman score, chrispin-Norman score and spirometry. Eur Radiol 17:1018–1024CrossRefPubMed

16.

Stadler A, Stiebellehner L, Jakob PM et al (2007) Quantitative and o(2) enhanced MRI of the pathologic lung: findings in emphysema, fibrosis, and cystic fibrosis. Int J Biomed Imaging 2007:23624CrossRefPubMedPubMedCentral

17.

Ciet P, Tiddens HAWM, Wielopolski PA et al (2015) Magnetic resonance imaging in children: common problems and possible solutions for lung and airways imaging. Pediatr Radiol. doi:10.1007/s00247-015-3420-y PubMedPubMedCentral

18.

Attariwala R, Picker W (2013) Whole body MRI: improved lesion detection and characterization with diffusion weighted techniques. J Magn Reson Imaging 38:253–268CrossRefPubMedPubMedCentral

19.

Luna A, Sánchez-Gonzalez J, Caro P (2011) Diffusion-weighted imaging of the chest. Magn Reson Imaging Clin N Am 19:69–94CrossRefPubMed

20.

Gaviani P, Schwartz RB, Hedley-Whyte ET et al (2005) Diffusion-weighted imaging of fungal cerebral infection. Am J Neuroradiol 26:1115–1121PubMed

21.

Moritani T, Kim J, Capizzano AA et al (2014) Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections. Br J Radiol 87:20140011CrossRefPubMedPubMedCentral

22.

Qi J, Olsen NJ, Price RR et al (2008) Diffusion-weighted imaging of inflammatory myopathies: polymyositis and dermatomyositis. J Magn Reson Imaging 27:212–217CrossRefPubMed

23.

Ream JM, Dillman JR, Adler J et al (2013) MRI diffusion-weighted imaging (DWI) in pediatric small bowel Crohn disease: correlation with MRI findings of active bowel wall inflammation. Pediatr Radiol 43:1077–1085CrossRefPubMed

24.

Miller MR, Hankinson J, Brusasco V et al (2005) Standardisation of spirometry. Eur Respir J 26:319–338CrossRefPubMed

25.

Tepper LA, Ciet P, Caudri D et al (2015) Validating chest MRI to detect and monitor cystic fibrosis lung disease in a pediatric cohort. Pediatr Pulmonol. doi:10.1002/ppul.23328

26.

Tepper LA, Utens EMWJ, Caudri D et al (2013) Impact of bronchiectasis and trapped air on quality of life and exacerbations in cystic fibrosis. Eur Respir J 42:371–379CrossRefPubMed

27.

Liu H, Liu Y, Yu T, Ye N (2010) Usefulness of diffusion-weighted MR imaging in the evaluation of pulmonary lesions. Eur Radiol 20:807–815CrossRefPubMed

28.

Tanaka R, Horikoshi H, Nakazato Y et al (2009) Magnetic resonance imaging in peripheral lung adenocarcinoma: correlation with histopathologic features. J Thorac Imaging 24:4–9CrossRefPubMed

29.

Uto T, Takehara Y, Nakamura Y et al (2009) Higher sensitivity and specificity for diffusion-weighted imaging of malignant lung lesions without apparent diffusion coefficient quantification. Radiology 252:247–254CrossRefPubMed

30.

Cohen J (1988) Statistical power analysis for the behavioral sciences, 2 edn. Routledge

31.

Geert V, Molenberghs G (2000) Linear mixed models for longitudinal data, 1st edn. doi:10.1007/978-1-4419-0300

32.

Burnham KP (2004) Multimodel Inference: understanding AIC and BIC in model selection. Sociol Methods Res 33:261–304CrossRef

33.

Deng Y, Li X, Lei Y, Liang C, Liu Z (2015) Use of diffusion-weighted magnetic resonance imaging to distinguish between lung cancer and focal inflammatory lesions: a comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient. Acta Radiol 1–8. doi:10.1177/0284185115586091

34.

Le Bihan D (2008) Intravoxel incoherent motion perfusion MR imaging: a wake-up call. Radiology 249:748–752CrossRefPubMed

35.

Chavhan GB, Alsabban Z, Babyn PS (2014) Diffusion-weighted imaging in pediatric body MR imaging: principles, technique, and emerging applications. Radiographics 34:E73–E88CrossRefPubMed

Titel: Diffusion weighted imaging in cystic fibrosis disease: beyond morphological imaging
verfasst von: Pierluigi Ciet
Goffredo Serra
Eleni Rosalina Andrinopoulou
Silvia Bertolo
Mirco Ros
Carlo Catalano
Stefano Colagrande
Harm A. W. M. Tiddens
Giovanni Morana
Publikationsdatum: 12.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4248-z

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Diffusion weighted imaging in cystic fibrosis disease: beyond morphological imaging