title: Oxygen-enhanced MRI, thin-section MDCT, and perfusion SPECT/CT: comparison of clinical implications to patient care for lung volume reduction surgery.
abstract: OBJECTIVE
  The purpose of our study was to prospectively and directly compare capability of O2-enhanced MRI, MDCT, and perfusion SPECT/CT to clinical outcome measurements in candidates for lung volume reduction surgery (LVRS).
  
  
  METHODS
  Twenty-five consecutive candidates for LVRS (20 men and five women; age range, 45-76 years) underwent MDCT, O2-enhanced MRI, and perfusion SPECT/CT before and after LVRS. Clinical outcomes for each candidate were evaluated in terms of differences between pre- and postoperative percentage forced expiratory volume in 1 second (%FEV1), Pao2, and 6-minute walking distance. Quantitatively assessed upper/lower lung ratios on O2-enhanced MRI, MDCT, and SPECT/CT were calculated from regional relative enhancement ratios, functional lung volumes, and radioisotope uptakes between upper and lower lungs. Qualitatively assessed upper/lower lung ratios on O2-enhanced MRI, MDCT, and SPECT/CT were estimated using visual scoring systems. To evaluate the correlation for individual upper/lower lung ratios and clinical outcomes, all upper/lower lung ratios were correlated with clinical outcomes. Improvements in mean relative enhancement ratio were directly correlated with clinical outcomes to assess the capability of O2-enhanced MRI to assess therapeutic effect.
  
  
  RESULTS
  All quantitatively (-0.63≤r≤-0.47, p<0.05) and qualitatively (0.41≤r≤0.57, p<0.05) assessed upper/lower lung ratios showed moderate and statistically significant correlation with clinical outcomes, and improvement in mean relative enhancement ratio showed moderate or good correlation, both statistically significant (-0.44≤r≤0.71, p<0.05).
  
  
  CONCLUSIONS
  O2-enhanced MRI shows potential for more accurate evaluation of postoperative clinical outcome for LVRS candidates than SPECT/CT and can be considered at least as reliable as MDCT.
authors.affiliation: Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan. yosirad@kobe-u.ac.jp
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Ohno
authors.forename: Mizuho
authors.initials: M
authors.lastname: Nishio
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Koyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Sumiaki
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takenaka
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: D000368:Aged; D003287:Contrast Media; D004417:Dyspnea; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging; D010100:Oxygen; D055420:Perfusion Imaging; D011013:Pneumonectomy; D049268:Positron-Emission Tomography; D011656:Pulmonary Emphysema / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D010100:Oxygen