Yoshiharu Ohno MD, PhD, Presenter: Research grant, Toshiba Corporation Research grant, Philips Healthcare Research grant, Bayer AG Research grant, DAIICHI SANKYO Group Research grant, Eisai Co, Ltd Research grant, Tanabe Mitubishi Corporation Research grant, Terumo Corporation

Mizuho Nishio MD, Abstract Co-Author: Nothing to Disclose

Hisanobu Koyama MD, Abstract Co-Author: Nothing to Disclose

Yumiko Onishi MD, Abstract Co-Author: Nothing to Disclose

Daisuke Takenaka MD, Abstract Co-Author: Nothing to Disclose

Seiji Koyama, Abstract Co-Author: Nothing to Disclose

Takeshi Yoshikawa MD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV

Sumiaki Matsumoto MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation

Keiko Matsumoto MD, Abstract Co-Author: Nothing to Disclose

Kazuro Sugimura MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Mitsubishi Corporation Research grant, Bayer AG Research grant, Eisai Co, Ltd Research grant, DAIICHI SANKYO Group Research Consultant, Shionogi & Co, Ltd

To prospectively and directly o compare quantitative and qualitative capabilities for therapeutic effect prediction in candidates for lung volume reduction surgery (LVRS) among O2-enhanced MRI, thin-section MDCT (quantitative CT) and perfusion SPECT/CT.

25 consecutive candidates for LVRS underwent thin-section CT, O2-enhanced MRI and perfusion SPECT /CT before and after LVRS.  All candidates were also assessed FEV1%, PaO2 and 6-minutes walk distance (6MWD) before and after LVRS. Clinical outcomes of LVRS were evaluated as follows: differences between pre- and postoperative FEV1%, PaO2 and 6-MWD. From signal intensity-time course curve of O2-enhanced MR data, relative-enhancement ratio (RER) map was generated. On quantitatively assessed MDCT, degree of emphysema was computationally assessed as functional lung volume (FLV). Then, upper lung field predominance of emphysema was determined as upper-lower lung ratio (U/L ratio) on each modality. Quantitatively assessed U/L ratios on O2-enhanced MRI, quantitative CT and SPECT/CT were calculated from regional RERs, FLVs and radioisotope uptakes between upper and lower lung field in each subject. Qualitatively assessed U/L ratios on O2-enhanced MRI, thin-section CT and SPECT/CT were estimated by using the visual scoring systems according to the past literatures. To determine the differences of U/L ratio between quantitative and qualitative methods on each modality, Bland-Altman’s analysis was performed. To compare capability for therapeutic effect prediction among all methods, differences of mean RER and U/L ratios of all methods between pre- and post LVRS were also correlated with clinical outcomes.

The limits of agreement between quantitative and qualitative methods on all modalities were follows: O2-enhanced MRI, 0.0±0.1, thin-section MDCT: 0.0±0.1, perfusion SPECT/CT: 0.0±0.2. All quantitatively and qualitatively assessed U/L ratios had significant and moderate correlations with improved FEV1%, PaO2 and 6MWD (-0.63<r<-0.45, p<0.05). 

O2-enhanced MRI has a potential for quantitative and qualitative prediction of therapeutic effect in candidates of LVRS, and considered at least as valuable as thin-section MDCT and perfusion SPECT/CT.

O2-enhanced MRI has a potential for quantitative and qualitative prediction of therapeutic effect in candidates of LVRS, and is considered at least as valuable as thin-section MDCT and SPECT/CT.

Ohno, Y, Nishio, M, Koyama, H, Onishi, Y, Takenaka, D, Koyama, S, Yoshikawa, T, Matsumoto, S, Matsumoto, K, Sugimura, K, Oxygen-enhanced MRI vs Quantitative CT vs Perfusion SPECT/CT: Quantitative and Qualitative Capability for Therapeutic Effect Prediction in Candidates for Lung Volume Reduction Surgery.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002290.html