Christian Schoenfeld, Presenter: Nothing to Disclose

Marcel Gutberlet DiplPhys, Abstract Co-Author: Nothing to Disclose

Jan Hinrichs MD, Abstract Co-Author: Nothing to Disclose

Julius Renne MD, Abstract Co-Author: Nothing to Disclose

Katja Hueper, Abstract Co-Author: Nothing to Disclose

Steven Sourbron PhD, Abstract Co-Author: Nothing to Disclose

Tobias Welte MD, Abstract Co-Author: Nothing to Disclose

Marius Hoeper, Abstract Co-Author: Nothing to Disclose

Frank K. Wacker MD, Abstract Co-Author: Research Grant, Siemens AG Research Grant, Pro Medicus Limited

Jens Vogel-Claussen MD, Abstract Co-Author: Nothing to Disclose

Quantification of regional lung perfusion is crucial for diagnosis and treatment response monitoring in patients with CTEPH. The hypothesis of our study is that pulmonary parenchymal blood flow can be quantified using a novel non-contrast perfusion-weighed FD method and correlates with pulmonary blood flow (PBF) derived from the clinically established DCE MRI method in patients with CTEPH.

23 patients with suspected CTEPH underwent lung MRI at 1.5T. FD MRI: Free breathing dynamic images were acquired in serial coronal planes covering the whole lung with a 2D Fast Low Angle Shot (FLASH) sequence with a temporal resolution of 3 frames/s for one minute. After non-rigid registration FD perfusion maps were calculated. DCE MRI: After bolus administration of 0.04 mmol/kg Gd-DOTA at 5cc/sec iv the first-pass of the contrast bolus was imaged using a dynamic 3D FLASH sequence. PBF maps were calculated on a pixel by pixel basis using model-independent deconvolution. Both lungs and corresponding normal and hypo-perfused lung areas were segmented on FD perfusion-maps and on DCE PBF-maps. Also phase contrast MRI measurements were performed in the right and left pulmonary arteries (PA) with a temporal resolution of 20ms.

A total of 192 corresponding lung areas were evaluated. There was a significant correlation between the perfusion-weighted values of the FD method and corresponding PBF derived by DCE MRI (r=0.65, p<0.001, PBF=-12.4+0.58×FD). After adjusting FD perfusion values according to the linear regression results, a Bland-Altman-analysis was performed showing a mean difference of -0.24 and a standard error of 1.85 (p=0,90). Central blood flow (BF) in the right and left PA were 2.1±0.9 and 2.7±1.2l/min respectively. There were significant correlations between the right to left ratio of central pulmonary BF with the corresponding ratio of PBF (r=0.88) and with the corresponding ratio of perfusion values derived by the FD method (r=0.63).

Our results show that regional perfusion of lung parenchyma can be assessed using the perfusion-weighted FD method in CTEPH patients. Perfusion-weighted FD values correlate well with regional PBF calculated by DCE MRI.

Clinical relevance statement: Perfusion of lung parenchyma can be assessed visually and quantitatively with perfusion-weighted FD in patients with CTEPH.

Schoenfeld, C, Gutberlet, M, Hinrichs, J, Renne, J, Hueper, K, Sourbron, S, Welte, T, Hoeper, M, Wacker, F, Vogel-Claussen, J, MRI Perfusion-weighted Fourier Decomposition (FD) Values Correlate with Pulmonary Blood Flow (PBF) Derived by Quantitative Dynamic Perfusion (DCE) MRI of the Lung in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH).  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13029046.html