title: Preliminary comparison of normalized T1 and non-contrast perfusion MRI assessments of regional lung disease in cystic fibrosis patients.
abstract: BACKGROUND
  Previous studies have shown that Magnetic Resonance Imaging (MRI) techniques can be used to non-invasively assess lung disease in CF patients. In this study, we compare the sensitivity of normalized T1 (nT1) and non-contrast perfusion MRI techniques to detect regional lung disease in CF patients.
  
  
  METHODS
  MRI data were obtained for eight adult CF patients without overt pulmonary exacerbation (FEV1=45-127%) and six healthy volunteers on a Siemens Espree 1.5T MRI scanner. Sagittal nT1 and perfusion data were acquired for each subject's left and right lungs. A region-of-interest analysis was used to calculate mean nT1 and perfusion values in the individual lobes of the left and right lungs for each subject.
  
  
  RESULTS
  In comparison to healthy controls, CF subjects showed a significant decrease in nT1 values in the upper lobe of the left lung as well as in the upper and anterior lobes of the right lung (p<0.001). Similar nT1 differences were observed with in the CF cohort in comparison to their respective posterior lobes (p<0.001). Pulmonary perfusion for the CF subjects was also significantly reduced in the upper lobe of the right lung (p<0.05). Significant correlations with spirometry were also observed for both nT1 (left upper lobe: p<0.01) and perfusion (left and right upper lobes (p≤0.05)). Additionally, significant correlations were observed between nT1 and perfusion in the upper lobes of the left (p=0.05) and right lungs (p=0.005).
  
  
  CONCLUSIONS
  This pilot study confirms that both the nT1 and non-contrast perfusion MRI techniques can sensitively detect regional lung changes in patients with CF. While both imaging methods were able to detect regional lung disease, the additional nT1 reductions in the CF patients suggests that nT1 may be more sensitive to regional CF lung disease.
authors.affiliation: Department of Radiology, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Shannon B
authors.initials: SB
authors.lastname: Donnola
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University, Cleveland, OH, USA; Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
authors.forename: Elliott C
authors.initials: EC
authors.lastname: Dasenbrook
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
authors.forename: David
authors.initials: D
authors.lastname: Weaver
authors.affiliation: Department of Radiology, Case Western Reserve University, Cleveland, OH, USA; Department of Urology, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Lan
authors.initials: L
authors.lastname: Lu
authors.affiliation: Department of Radiology, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Karishma
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Lake Ridge Academy, North Ridgeville, OH, USA.
authors.forename: Anjali
authors.initials: A
authors.lastname: Prabhakaran
authors.affiliation: Department of Radiology, Case Western Reserve University, Cleveland, OH, USA; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA; Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Chmiel
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University, Cleveland, OH, USA; Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: McBennett
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Konstan
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Department of Genetics, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Drumm
authors.affiliation: Department of Radiology, Case Western Reserve University, Cleveland, OH, USA; Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA. Electronic address: caf@case.edu.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Flask
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000503:physiopathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
keywords: Imaging; Lung disease; Magnetic Resonance Imaging; Perfusion; Relaxometry