AUTHOR=Doellinger Felix , Bauman Grzegorz , Roehmel Jobst , Stahl Mirjam , Posch Helena , Steffen Ingo G. , Pusterla Orso , Bieri Oliver , Wielpütz Mark O. , Mall Marcus A. 

TITLE=Contrast agent-free functional magnetic resonance imaging with matrix pencil decomposition to quantify abnormalities in lung perfusion and ventilation in patients with cystic fibrosis

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1349466

DOI=10.3389/fmed.2024.1349466

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Background</title><p>Previous studies showed that contrast-enhanced (CE) morpho-functional magnetic resonance imaging (MRI) detects abnormalities in lung morphology and perfusion in patients with cystic fibrosis (CF). Novel matrix pencil decomposition MRI (MP-MRI) enables quantification of lung perfusion and ventilation without intravenous contrast agent administration.</p></sec><sec id="sec2"><title>Objectives</title><p>To compare MP-MRI with established morpho-functional MRI and spirometry in patients with CF.</p></sec><sec id="sec3"><title>Methods</title><p>Thirty-nine clinically stable patients with CF (mean age 21.6 ± 10.7 years, range 8–45 years) prospectively underwent morpho-functional MRI including CE perfusion MRI, MP-MRI and spirometry. Two blinded chest radiologists assessed morpho-functional MRI and MP-MRI employing the validated chest MRI score. In addition, MP-MRI data were processed by automated software calculating perfusion defect percentage (QDP) and ventilation defect percentage (VDP).</p></sec><sec id="sec4"><title>Results</title><p>MP perfusion score and QDP correlated strongly with the CE perfusion score (both <italic>r</italic> = 0.81; <italic>p</italic> &lt; 0.01). MP ventilation score and VDP showed strong inverse correlations with percent predicted FEV1 (<italic>r</italic> = −0.75 and <italic>r</italic> = −0.83; <italic>p</italic> &lt; 0.01). The comparison of visual and automated parameters showed that both MP perfusion score and QDP, and MP ventilation score and VDP were strongly correlated (<italic>r</italic> = 0.74 and <italic>r</italic> = 0.78; both <italic>p</italic> &lt; 0.01). Further, the MP perfusion score and MP ventilation score, as well as QDP and VDP were strongly correlated (<italic>r</italic> = 0.88 and <italic>r</italic> = 0.86; both <italic>p</italic> &lt; 0.01).</p></sec><sec id="sec5"><title>Conclusion</title><p>MP-MRI detects abnormalities in lung perfusion and ventilation in patients with CF without intravenous or inhaled contrast agent application, and correlates strongly with the well-established CE perfusion MRI score and spirometry. Automated analysis of MP-MRI may serve as quantitative noninvasive outcome measure for diagnostic monitoring and clinical trials.</p></sec>