Comparison of diagnostic quality of 3D ultrashort-echo-time techniques for pulmonary magnetic resonance imaging in free-breathing. (May 2023)

• Record Type: Journal Article
• Authors: Metz, Corona; Weng, Andreas Max; Böckle, David; Heidenreich, Julius Frederik; Slawig, Anne; Benkert, Thomas; Kraus, Sabrina; Köstler, Herbert; Veldhoen, Simon
• Is Part Of: Acta radiologica. Volume 64:Number 5(2023)
• Page Start: 1851
• Page End: 1858
• Publication Date: 2023-05
• Subjects: Three-dimensional ultrashort echo time -- pulmonary magnetic resonance imaging -- free-breathing -- stack-of-spirals trajectory -- radial trajectory; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/02841851231151366
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Ultrashort-echo-time (UTE) sequences have been developed to overcome technical limitations of pulmonary magnetic resonance imaging (MRI). Recently, it has been shown that UTE sequences with breath-hold allow rapid image acquisition with sufficient image quality. However, patients with impaired respiration require alternative acquisition strategies while breathing freely. Purpose: To compare the diagnostic performance of free-breathing three-dimensional (3D)-UTE sequences with different trajectories based on pulmonary imaging of immunocompromised patients. Material and Methods: In a prospective study setting, two 3D-UTE sequences performed in free-breathing and exploiting non-Cartesian trajectories—one using a stack-of-spirals and the other exploiting a radial trajectory—were acquired at 3 T in patients undergoing hematopoietic stem cell transplantation. Two radiologists assessed the images regarding presence of pleural effusions and pulmonary infiltrations. Computed tomography (CT) was used as reference. Results: A total of 28 datasets, each consisting of free-breathing 3D-UTE MRI with the two sequence techniques and a reference CT scan, were acquired in 20 patients. Interrater agreement was substantial for pulmonary infiltrations using both sequence techniques (κ = 0.77 − 0.78). Regarding pleural effusions, agreement was almost perfect in the stack-of-spirals (κ = 0.81) and moderate in the radial sequence (κ = 0.59). No significant differences in detectability of the assessed pulmonary pathologies were observed between both 3D-UTE sequence techniques ( P > 0.05), and their level of agreement was substantial throughout (κ = 0.62–0.81). Both techniques provided high sensitivities and specificities (79%–100%) for the detection of pulmonary infiltrations and pleural effusions compared to reference CT. Conclusion: The diagnostic performance of the assessed 3D-UTE MRI sequences was similar. Both sequences enable the detection of typical inflammatory lung pathologies.