Volumetric dynamic oxygen-enhanced MRI (OE-MRI): comparison with CT Brody score and lung function in cystic fibrosis patients

Objectives: To demonstrate, in patients with cystic fibrosis (CF), the correlation between three-dimensional dynamic oxygen-enhanced magnetic resonance imaging (OE-MRI) measurements and computed tomography Brody score (CF-CT) and lung function testing (LFT). Methods: Twenty-one patients (median age, 25 years; female, n = 8) with a range of CF lung disease and five healthy volunteers (median age, 31 years; female, n = 2) underwent OE-MRI performed on a 1.5-T MRI scanner. Coronal volumes were acquired while patients alternately breathed room air and 100% oxygen. Pre-oxygen T₁ was measured. Dynamic series of T₁-weighted volumes were then obtained while breathing oxygen. T₁-parameter maps were generated and the following OE-MRI parameters were measured: oxygen uptake (ΔPO_2max), wash-in time and wash-out time. High-resolution CT and LFT were performed. The relationship between CF-CT, LFT and OE-MRI parameters were evaluated using Pearson correlation for the whole lung and regionally. Results: Mean CF-CT was 24.1±17.1. Mean ΔPO_2max and mean wash-in as well as skewness of wash-out showed significant correlation with CF-CT (ΔPO_2max: r = -0.741, p < 0.001; mean wash-in: r = 0.501, p = 0.017; skewness of wash-out: r = 0.597, p = 0.001). There was significant correlation for the whole lung and regionally between LFT parameters and OE-MR (ΔPO_2max: r = 0.718, p < 0.001; wash-in: r = -0.576, p = 0.003; wash-out skewness: r = -0.552, p = 0.004). Conclusions: Functional lung imaging using OE-MRI has the capability to assess the severity of CF lung disease and shows a significant correlation with LFT and CF-CT. Key points: • Oxygen-enhanced MRI might play a future role in evaluation and follow-up of cystic fibrosis.• Heterogeneity of parameter maps reflects localised functional impairment in cystic fibrosis.• Avoidance of cumulative radiation burden in CF is feasible using OE-MRI.