Background: Free-breathing phase-resolved functional lung (PREFUL)-MRI may be useful for treatment monitoring in chronic obstructive pulmonary disease (COPD) patients with dyspnea. PREFUL test-retest reliability is essential for clinical application.
Purpose: To measure the repeatability of PREFUL-MRI ventilation (V) and perfusion (Q) parameters.
Study Type: Retrospective and prospective.
Population: A total of 28 COPD patients and 57 healthy subjects.
Field Strength/sequence: 1.5T MRI/2D spoiled gradient echo imaging.
Assessment: V and Q lung parameter maps based on three coronal slices were obtained at baseline and after 14 days (COPD patients) or after a short pause outside the scanner (healthy subjects). Regional ventilation (RVent) and imaging flow volume loops by cross-correlation (ccVent) were quantified. Q was normalized to the signal of the main pulmonary artery (Q ) and quantified (Q ). Pulmonary pulse wave transit time (pPTT), voxel-by-voxel (regional), and whole lung (global) ventilation defect percentage based on RVent (VDP ) and ccVent (VDP ), perfusion defect percentage (QDP), and ventilation/perfusion match based on RVent (VQM ) and ccVent (VQM ) were calculated.
Statistical Tests: Regional V and Q were analyzed globally for each subject. Each parameter's median of scans 1 and 2 were assessed by Wilcoxon sign rank test. A parameter's repeatability was analyzed by Bland-Altman analyses, coefficients of variation, intraclass correlation coefficients (ICC), and power calculations. The regional voxel repeatability was examined by calculating the Sørensen-Dice coefficient.
Results: There was no bias and no significant differences between the first and second MRI for any parameters (P > 0.05). Coefficient of variation ranged from 2.26% (ccVent) to 19.31% (QDP), ICC from 0.93 (QDP) to 0.60 (pPTT), the smallest detectable difference was 0.002 ccVent. Regional comparison showed the highest overlap (84%) in VDP in healthy voxels and the lowest (53%) in VDP defect voxels.
Data Conclusion: V and Q PREFUL-MRI parameters were repeatable over two scan sessions in both healthy controls and COPD patients.
Level Of Evidence: 2 TECHNICAL EFFICACY STAGE: 2.
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