Daniel Maxien MD, Presenter: Nothing to Disclose

Michael Ingrisch, Abstract Co-Author: Nothing to Disclose

Felix G. Meinel MD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Olaf Dietrich PhD, Abstract Co-Author: Nothing to Disclose

Konstantin Nikolaou MD, Abstract Co-Author: Speakers Bureau, Siemens AG Speakers Bureau, Bracco Group Speakers Bureau, Bayer AG

Examinations in breath hold (BH) are often difficult for patients suffering from lung diseases. Recently the quantitative assessment of pulmonary perfusion using dynamic contrast-enhanced (DCE)-MRI with a measurement during free breathing (FB) was demonstrated. In this study, we compared the reproducibility of the quantitative assessment of pulmonary perfusion during FB with the reproducibility of the gold standard BH measurements.

10 healthy, male volunteers underwent DCE-MRI on a 1.5T scanner for the assessment of pulmonary perfusion, using an accelerated 3D view sharing gradient-echo sequence. Each volunteer was examined twice at intervals of one week +/- one day. Each of these two examinations included a BH and a FB DCE-MRI acquisition, at intervals of at least 20min. Hence, 40 DCE MRI datasets were acquired in total. Pulmonary plasma flow (PPF) and pulmonary plasma volume (PPV) were determined pixel-wise, using a one-compartment model. For FP and BH measurements, the intra-class correlation coefficient (ICC) and the coefficients of variation (CV) between first and second measurement were calculated to assess test-retest reproducibility. Differences of CV between FB and BH measurements were assessed with a non-parametric, paired two-sided Wilcoxon signed rank test. Reproducibility R of PPF and PPV was calculated as root-mean-square average of CV.

The ICC for both measured quantitative parameters was lower during BH than in FB technique (PPF: 0.37 vs. 0.69; PPV: 0.69 vs. 0.84). Additionally, the R values of the BH measurements were higher than the corresponding R values of the FB measurements (PPF 0.32 vs. 0.16; PPV: 0.18 vs. 0.10). Overall, CV is significantly lower for the FB measurements both for PPF (p=0.008) and PPV (p=0.03). ICC values of PPF and PPV are higher for FB than for BH measurements and test-retest reproducibility is significantly better (p<0.05) for FB than for BH measurements.

A free-breathing measurement of pulmonary perfusion is suitable for the quantification of pulmonary perfusion and leads to parameter estimates with a better reproducibility than the conventionally used measurements during breath hold.

Regarding the reproducibility, this study demonstrates that the desirable quantitative assessment of pulmonary perfusion during free breathing might be superior to the common breath hold technique.

Maxien, D, Ingrisch, M, Meinel, F, Reiser, M, Dietrich, O, Nikolaou, K, Reproducibility of Breath-hold and Free-breathing Quantitative Pulmonary Perfusion MRI.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13017462.html