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Dynamic Oxygen-Enhanced MRI Versus Quantitative CT: Pulmonary Functional Loss Assessment and Clinical Stage Classification of Smoking-Related COPD

¹ Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
² Philips Medical Systems, Tokyo, Japan.

OBJECTIVE. The purpose of the present study is to prospectively compare the capability of dynamic oxygen-enhanced MRI and quantitative CT for pulmonary functional loss assessment and clinical stage classification of smoking-related chronic obstructive pulmonary disease (COPD).

SUBJECTS AND METHODS. Ten nonsmoking and 61 consecutive smoking-related COPD subjects underwent dynamic oxygen-enhanced MRI, CT, and pulmonary function tests. COPD subjects were classified into four clinical stages on the basis of the ATS–ERS guidelines. Wash-in time and relative enhancement ratio maps were generated by pixel-by-pixel analyses. Mean wash-in time and relative enhancement ratio were determined as averages of region of interest (ROI) measurements. CT-based functional lung volumes were measured on quantitative CT using the density-masked CT technique. For comparison of assessment capability for smoking-related functional loss, the three parameters were correlated with the percentage predicted forced expiratory volume in 1 second (%FEV₁) and the percentage predicted diffusing capacity of the lung for carbon monoxide corrected for alveolar volume (%DL_CO/VA). To determine the clinical stage classification capability, these parameters were statistically compared for nonsmoking subjects and all clinical stages of smoking-related COPD subjects.

RESULTS. Correlation between mean wash-in time and %FEV₁ (r = –0.74, p < 0.0001) and between mean relative enhancement ratio and %DL_CO /VA (r = 0.66, p < 0.0001) was better than that between CT-based functional lung volume and either %FEV₁ (r = 0.61, p < 0.0001) or %DL_CO/VA (r = 0.56, p < 0.0001). Mean wash-in time showed a significant difference between nonsmoking and smoking-related COPD subjects at all clinical stages (p < 0.05).

CONCLUSION. Dynamic oxygen-enhanced MRI has potential for pulmonary functional loss assessment and clinical stage classification of smoking-related COPD as does quantitative CT.

Keywords: chronic obstructive pulmonary disease (COPD) • lung • MRI • oxygen • smoking • ventilation

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				Y. Ohno, T. Iwasawa, J. B. Seo, H. Koyama, H. Takahashi, Y.-M. Oh, Y. Nishimura, and K. Sugimura Oxygen-enhanced Magnetic Resonance Imaging versus Computed Tomography: Multicenter Study for Clinical Stage Classification of Smoking-related Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., May 15, 2008; 177(10): 1095 - 1102. [Abstract] [Full Text] [PDF]