Volume‐Controlled 19F MR Ventilation Imaging of Fluorinated Gas

• Published in: Journal of magnetic resonance imaging Vol. 57; no. 4; pp. 1114 - 1128
• Main Authors: Obert, Arnd J., Kern, Agilo L., Gutberlet, Marcel, Voskrebenzev, Andreas, Kaireit, Till F., Crisosto, Cristian, Greer, Mark, Krause, E. Tobias, Wacker, Frank, Vogel‐Claussen, Jens
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2023; Wiley Subscription Services, Inc
• Subjects: 19F; Chronic obstructive pulmonary disease; Coefficient of variation; Correlation coefficient; Correlation coefficients; Field strength; inspiratory volume control; Lung diseases; Lungs; Magnetic resonance imaging; Mathematical analysis; Medical imaging; Obstructive lung disease; Parameters; Population studies; pulmonary MRI; repeatability; Reproducibility; Respiration; Respiratory function; Statistical analysis; Statistical tests; Ventilation; Volume controls
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.28385

Background 19F MRI of inhaled gas tracers has developed into a promising tool for pulmonary diagnostics. Prior to clinical use, the intersession repeatability of acquired ventilation parameters must be quantified and maximized. Purpose To evaluate repeatability of static and dynamic 19F ventilation parameters and correlation with predicted forced expiratory volume in 1 second (FEV1%pred) with and without inspiratory volume control. Study Type Prospective. Population A total of 30 healthy subjects and 26 patients with chronic obstructive pulmonary disease (COPD). Field Strength/Sequence Three‐dimensional (3D) gradient echo pulse sequence with golden‐angle stack‐of‐stars k‐space encoding at 1.5 T. Assessment All study participants underwent 19F ventilation MRI over eight breaths with inspiratory volume control (w VC) and without inspiratory volume control (w/o VC), which was repeated within 1 week. Ventilated volume percentage (VVP), fractional ventilation (FV), and wash‐in time (WI) were computed. Lung function testing was conducted on the first visit. Statistical Tests Correlation between imaging and FEV1%pred was measured using Pearson correlation coefficient (r). Differences in imaging parameters between first and second visit were analyzed using paired t‐test. Repeatability was quantified using intraclass correlation coefficient (ICC) and coefficient of variation (CoV). Minimum detectable effect size (MDES) was calculated with a power analysis for study size n = 30 and a power of 0.8. All hypotheses were tested with a significance level of 5% two sided. Results Strong and moderate linear correlations with FEV1%pred for COPD patients were found in almost all imaging parameters. The ICC w VC exceeds the ICC w/o VC for all imaging parameters. CoV was significantly lower w VC for initial VVP in COPD patients, FV, CoV FV, WI and standard deviation (SD) of WI. MDES of all imaging parameters were smaller w VC. Data Conclusion 19F gas wash‐in MRI with inspiratory volume control increases the correlation and repeatability of imaging parameters with lung function testing. Evidence Level 2 Technical Efficacy Stage 2