Pierluigi Ciet1,2,3, Goffredo Serra4, Eleni Rosalina Andrinopoulou5, Silvia Bertolo3, Mirco Ros6, Carlo Catalano4, Stefano Colagrande7, Harm A W M Tiddens1,2, Giovanni Morana8. 1. Department of Radiology, Erasmus Medical Center, Rotterdam, Netherlands. 2. Department of Paediatrics, Respiratory Medicine and Allergology, Erasmus Medical Center - Sophia Children's Hospital, P.O. Box 2060, Wytemaweg 80, Rotterdam, 3000 CB, Zuid-Holland, Netherlands. 3. Department of Radiology, Ca' Foncello - General Hospital, Piazzale Ospedale, 1, 31100, Treviso, Italy. 4. Department of Radiology, University of Rome "Sapienza", Rome, Italy. 5. Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands. 6. Department of Pediatrics, Ca' Foncello Hospital, Treviso, Italy. 7. Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi., Largo Brambilla 3, Florence, 50134, Italy. 8. Department of Radiology, Ca' Foncello - General Hospital, Piazzale Ospedale, 1, 31100, Treviso, Italy. gmorana@ulss.tv.it.
Abstract
OBJECTIVES: To explore the feasibility of diffusion-weighted imaging (DWI) to assess inflammatory lung changes in patients with Cystic Fibrosis (CF) METHODS: CF patients referred for their annual check-up had spirometry, chest-CT and MRI on the same day. MRI was performed in a 1.5 T scanner with BLADE and EPI-DWI sequences (b = 0-600 s/mm2). End-inspiratory and end-expiratory scans were acquired in multi-row scanners. DWI was scored with an established semi-quantitative scoring system. DWI score was correlated to CT sub-scores for bronchiectasis (CF-CTBE), mucus (CF-CTmucus), total score (CF-CTtotal-score), FEV1, and BMI. T-test was used to assess differences between patients with and without DWI-hotspots. RESULTS: Thirty-three CF patients were enrolled (mean 21 years, range 6-51, 19 female). 4 % (SD 2.6, range 1.5-12.9) of total CF-CT alterations presented DWI-hotspots. DWI-hotspots coincided with mucus plugging (60 %), consolidation (30 %) and bronchiectasis (10 %). DWItotal-score correlated (all p < 0.0001) positively to CF-CTBE (r = 0.757), CF-CTmucus (r = 0.759) and CF-CTtotal-score (r = 0.79); and negatively to FEV1 (r = 0.688). FEV1 was significantly higher (p < 0.0001) in patients without DWI-hotspots. CONCLUSIONS: DWI-hotspots strongly correlated with radiological and clinical parameters of lung disease severity. Future validation studies are needed to establish the exact nature of DWI-hotspots in CF patients. KEY POINTS: • DWI hotspots only partly overlapped structural abnormalities on morphological imaging • DWI strongly correlated with radiological and clinical indicators of CF-disease severity • Patients with more DWI hotspots had lower lung function values • Mucus score best predicted the presence of DWI-hotspots with restricted diffusion.
OBJECTIVES: To explore the feasibility of diffusion-weighted imaging (DWI) to assess inflammatory lung changes in patients with Cystic Fibrosis (CF) METHODS: CF patients referred for their annual check-up had spirometry, chest-CT and MRI on the same day. MRI was performed in a 1.5 T scanner with BLADE and EPI-DWI sequences (b = 0-600 s/mm2). End-inspiratory and end-expiratory scans were acquired in multi-row scanners. DWI was scored with an established semi-quantitative scoring system. DWI score was correlated to CT sub-scores for bronchiectasis (CF-CTBE), mucus (CF-CTmucus), total score (CF-CTtotal-score), FEV1, and BMI. T-test was used to assess differences between patients with and without DWI-hotspots. RESULTS: Thirty-three CF patients were enrolled (mean 21 years, range 6-51, 19 female). 4 % (SD 2.6, range 1.5-12.9) of total CF-CT alterations presented DWI-hotspots. DWI-hotspots coincided with mucus plugging (60 %), consolidation (30 %) and bronchiectasis (10 %). DWItotal-score correlated (all p < 0.0001) positively to CF-CTBE (r = 0.757), CF-CTmucus (r = 0.759) and CF-CTtotal-score (r = 0.79); and negatively to FEV1 (r = 0.688). FEV1 was significantly higher (p < 0.0001) in patients without DWI-hotspots. CONCLUSIONS: DWI-hotspots strongly correlated with radiological and clinical parameters of lung disease severity. Future validation studies are needed to establish the exact nature of DWI-hotspots in CF patients. KEY POINTS: • DWI hotspots only partly overlapped structural abnormalities on morphological imaging • DWI strongly correlated with radiological and clinical indicators of CF-disease severity • Patients with more DWI hotspots had lower lung function values • Mucus score best predicted the presence of DWI-hotspots with restricted diffusion.
Entities:
Keywords:
Cystic fibrosis; Diffusion magnetic resonance imaging; Disease exacerbation; Magnetic resonance imaging; Pulmonary inflammation
Authors: Edwin J R van Beek; Catherine Hill; Neil Woodhouse; Stanislao Fichele; Sally Fleming; Bridget Howe; Sandra Bott; Jim M Wild; Christopher J Taylor Journal: Eur Radiol Date: 2006-08-29 Impact factor: 5.315
Authors: Leonie A Tepper; Pierluigi Ciet; Daan Caudri; Alexandra L Quittner; Elisabeth M W J Utens; Harm A W M Tiddens Journal: Pediatr Pulmonol Date: 2015-10-05
Authors: Harm A W M Tiddens; Stephen M Stick; Jim M Wild; Pierluigi Ciet; Geoffrey J M Parker; Armin Koch; Jens Vogel-Claussen Journal: Pediatr Pulmonol Date: 2015-10
Authors: Wieying Kuo; Pierluigi Ciet; Harm A W M Tiddens; Wei Zhang; R Paul Guillerman; Marcel van Straten Journal: Am J Respir Crit Care Med Date: 2014-06-01 Impact factor: 21.405
Authors: Justin M Ream; Jonathan R Dillman; Jeremy Adler; Shokoufeh Khalatbari; Jonathan B McHugh; Peter J Strouse; Muhammad Dhanani; Benjamin Shpeen; Mahmoud M Al-Hawary Journal: Pediatr Radiol Date: 2013-08-16
Authors: Martina Pecoraro; Stefano Cipollari; Livia Marchitelli; Emanuele Messina; Maurizio Del Monte; Nicola Galea; Maria Rosa Ciardi; Marco Francone; Carlo Catalano; Valeria Panebianco Journal: Radiol Med Date: 2021-07-12 Impact factor: 3.469