Comparison of diagnostic quality of 3D ultrashort-echo-time techniques for pulmonary magnetic resonance imaging in free-breathing

Abstract

Background

Ultrashort-echo-time (UTE) sequences have been developed to overcome technical limitations of pulmonary magnetic resonance imaging (MRI). Recently, it has been shown that UTE sequences with breath-hold allow rapid image acquisition with sufficient image quality. However, patients with impaired respiration require alternative acquisition strategies while breathing freely.

Purpose

To compare the diagnostic performance of free-breathing three-dimensional (3D)-UTE sequences with different trajectories based on pulmonary imaging of immunocompromised patients.

Material and Methods

In a prospective study setting, two 3D-UTE sequences performed in free-breathing and exploiting non-Cartesian trajectories—one using a stack-of-spirals and the other exploiting a radial trajectory—were acquired at 3 T in patients undergoing hematopoietic stem cell transplantation. Two radiologists assessed the images regarding presence of pleural effusions and pulmonary infiltrations. Computed tomography (CT) was used as reference.

Results

A total of 28 datasets, each consisting of free-breathing 3D-UTE MRI with the two sequence techniques and a reference CT scan, were acquired in 20 patients. Interrater agreement was substantial for pulmonary infiltrations using both sequence techniques (κ = 0.77 − 0.78). Regarding pleural effusions, agreement was almost perfect in the stack-of-spirals (κ = 0.81) and moderate in the radial sequence (κ = 0.59). No significant differences in detectability of the assessed pulmonary pathologies were observed between both 3D-UTE sequence techniques (P > 0.05), and their level of agreement was substantial throughout (κ = 0.62–0.81). Both techniques provided high sensitivities and specificities (79%–100%) for the detection of pulmonary infiltrations and pleural effusions compared to reference CT.

Conclusion

The diagnostic performance of the assessed 3D-UTE MRI sequences was similar. Both sequences enable the detection of typical inflammatory lung pathologies.

Keywords

Three-dimensional ultrashort echo time pulmonary magnetic resonance imaging free-breathing stack-of-spirals trajectory radial trajectory

Get full access to this article

View all access options for this article.

References

Xue

Song

. Comparison of lung T2* during free-breathing at 1.5 T and 3.0 T with ultrashort echo time imaging. Magn Reson Med 2011;66:248–254.

Wielputz

Triphan

SMF

Ohno

, et al. Outracing lung signal decay - potential of ultrashort echo time MRI. Rofo 2019;191:415–423.

Ohno

Koyama

Yoshikawa

, et al. Pulmonary high-resolution ultrashort TE MR imaging: comparison with thin-section standard- and low-dose computed tomography for the assessment of pulmonary parenchyma diseases. J Magn Reson Imaging 2016;43:512–532.

Gai

Malayeri

Agarwal

, et al. Evaluation of optimized breath-hold and free-breathing 3D ultrashort echo time contrast agent-free MRI of the human lung. J Magn Reson Imaging 2016;43:1230–1238.

Takizawa

Hanada

Oka

, et al. A robust ultrashort TE (UTE) imaging method with corrected k-space trajectory by using parametric multiple function model of gradient waveform. IEEE Trans Med Imaging 2013;32:306–316.

Glover

Pauly

. Projection reconstruction techniques for reduction of motion effects in MRI. Magn Reson Med 1992;28:275–289.

Balasch A, Metze P, Stumpf K, et al. 2D ultrashort echo-time functional lung imaging. J Magn Reson Imaging 2020 Dec;52(6):1637–1644. doi:10.1002/jmri.27269.

Jiang

Ong

Johnson

, et al. Motion robust high resolution 3D free-breathing pulmonary MRI using dynamic 3D image self-navigator. Magn Reson Med 2018;79:2954–2967.

Weick

Breuer

Ehses

, et al. DC-gated high resolution three-dimensional lung imaging during free-breathing. J Magn Reson Imaging 2013;37:727–732.

10.

Higano

Fleck

Spielberg

, et al. Quantification of neonatal lung parenchymal density via ultrashort echo time MRI with comparison to CT. J Magn Reson Imaging 2017;46:992–1000.

11.

Metz C, Böckle D, Heidenreich JF, et al. Pulmonary imaging of immunocompromised patients during hematopoietic stem cell transplantation using non-contrast-enhanced three-dimensional ultrashort echo time (3D-UTE) MRI. Rofo. 2022 Jan;194(1):39–48. doi:10.1055/a-1535-2341.

12.

Schmidt

Yang

Keegan

, et al. Non-breath-hold lung magnetic resonance imaging with real-time navigation. MAGMA 1997;5:123–128.

13.

Mugler JP, Meyer CH, Pfeuffer J, et al. Accelerated stack-of-spirals breath-hold UTE lung imaging. Proc Intl Soc Mag Reson Med 2017; 4904.

14.

Qian

Boada

. Acquisition-weighted stack of spirals for fast high-resolution three-dimensional ultra-short echo time MR imaging. Magn Reson Med 2008;60:135–145.

15.

Willmering

Robison

Wang

, et al. Implementation of the FLORET UTE sequence for lung imaging. Magn Reson Med 2019;82:1091–1100.

16.

Cha

Park

Paek

, et al. Free-breathing ultrashort echo time lung magnetic resonance imaging using stack-of-spirals acquisition: a feasibility study in oncology patients. Magn Reson Imaging 2018;51:137–143.

17.

Bae

Jeon

Hwang

, et al. Comparison of lung imaging using three-dimensional ultrashort echo time and zero echo time sequences: preliminary study. Eur Radiol 2019;29:2253–2262.

18.

Heidenreich JF, Veldhoen S, Metz C, et al. Functional MRI of the lungs using single breath-hold and self-navigated ultrashort echo time sequences. Radiol Cardiothorac Imaging 2020 Jun 25;2(3):e190162. doi:10.1148/ryct.2020190162.

19.

Barger

Block

Toropov

, et al. Time-resolved contrast-enhanced imaging with isotropic resolution and broad coverage using an undersampled 3D projection trajectory. Magn Reson Med 2002;48:297–305.

20.

Johnson

Fain

Schiebler

, et al. Optimized 3D ultrashort echo time pulmonary MRI. Magn Reson Med 2013;70:1241–1250.

21.

Higano

Hahn

Tkach

, et al. Retrospective respiratory self-gating and removal of bulk motion in pulmonary UTE MRI of neonates and adults. Magn Reson Med 2017;77:1284–1295.

22.

Mendes Pereira

Wech

Weng

, et al. UTE-SENCEFUL: first results for 3D high-resolution lung ventilation imaging. Magn Reson Med 2019;81(4):2464–2473.

23.

Lustig

Pauly

. SPIRit: iterative self-consistent parallel imaging reconstruction from arbitrary k-space. Magn Reson Med 2010;64:457–471.

24.

Mendes Pereira L. Weng AM, Wech T., et al. UTE-SENCEFUL with a coil clustering algorithm for automatic DC gating. Proc Intl Soc Mag Reson Med 2019; 4102.

25.

Pruessmann

Weiger

Bornert

, et al. Advances in sensitivity encoding with arbitrary k-space trajectories. Magn Reson Med 2001;46:638–651.

26.

Hansell

Bankier

MacMahon

, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008;246:697–722.

27.

Attenberger

Morelli

Henzler

, et al. 3 Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: initial results in comparison to HRCT. Eur J Radiol 2014;83:e61–e66.

28.

Landis

Koch

. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174.

29.

Ekinci

Yucel Ucarkus

Okur

, et al. MRI of pneumonia in immunocompromised patients: comparison with CT. Diagn Interv Radiol 2017;23:22–28.

30.

Brenner

Hall

. Computed tomography--an increasing source of radiation exposure. N Engl J Med 2007;357:2277–2284.