title: Validation of Fourier decomposition MRI with dynamic contrast-enhanced MRI using visual and automated scoring of pulmonary perfusion in young cystic fibrosis patients.
abstract: OBJECTIVE
  To validate Fourier decomposition (FD) magnetic resonance (MR) imaging in cystic fibrosis (CF) patients with dynamic contrast-enhanced (DCE) MR imaging.
  
  
  METHODS
  Thirty-four CF patients (median age 4.08 years; range 0.16-30) were examined on a 1.5-T MR imager. For FD MR imaging, sets of lung images were acquired using an untriggered two-dimensional balanced steady-state free precession sequence. Perfusion-weighted images were obtained after correction of the breathing displacement and Fourier analysis of the cardiac frequency from the time-resolved data sets. DCE data sets were acquired with a three-dimensional gradient echo sequence. The FD and DCE images were visually assessed for perfusion defects by two readers independently (R1, R2) using a field based scoring system (0-12). Software was used for perfusion impairment evaluation (R3) of segmented lung images using an automated threshold. Both imaging and evaluation methods were compared for agreement and tested for concordance between FD and DCE imaging.
  
  
  RESULTS
  Good or acceptable intra-reader agreement was found between FD and DCE for visual and automated scoring: R1 upper and lower limits of agreement (ULA, LLA): 2.72, -2.5; R2: ULA, LLA: ± 2.5; R3: ULA: 1.5, LLA: -2. A high concordance was found between visual and automated scoring (FD: 70-80%, DCE: 73-84%).
  
  
  CONCLUSIONS
  FD MR imaging provides equivalent diagnostic information to DCE MR imaging in CF patients. Automated assessment of regional perfusion defects using FD and DCE MR imaging is comparable to visual scoring but allows for percentage-based analysis.
authors.affiliation: German Cancer Research Center, Division of Medical Physics in Radiology, Im Neuenheimer Feld 223, 69120 Heidelberg, Germany. Electronic address: g.bauman@dkfz.de.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Bauman
authors.forename: Michael
authors.initials: M
authors.lastname: Puderbach
authors.forename: Tobias
authors.initials: T
authors.lastname: Heimann
authors.forename: Annette
authors.initials: A
authors.lastname: Kopp-Schneider
authors.forename: Eva
authors.initials: E
authors.lastname: Fritzsching
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Mall
authors.forename: Monika
authors.initials: M
authors.lastname: Eichinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003550:Cystic Fibrosis / Q000150:complications / Q000473:pathology*; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Contrast media; Cystic fibrosis; Lung; Magnetic resonance imaging; Perfusion