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Asthma: comparison of dynamic oxygen-enhanced MR imaging and quantitative thin-section CT for evaluation of clinical
Yoshiharu Ohno1, Mizuho Nishio, Hisanobu Koyama
1From the Advanced Biomedical Imaging Research Center (Y.O., M.N., T.Y., S.M., K.S.), Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., M.N., T.Y., S.M.), and Division of Radiology, Department of Radiology (H.K., S.S.), Kobe University Graduate School of Medicine, Kobe, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan; and Philips Electronics Japan, Tokyo, Japan (M.O., M.v.C.).
Purpose:
To compare the use of dynamic oxygen-enhanced magnetic resonance (MR) imaging with the use of quantitatively assessed computed tomography (CT) for assessment of clinical stage and evaluation of pulmonary functional change due to treatment in patients with asthma.
Materials And Methods:
The institutional review board of Kobe University Hospital approved this study, and written informed consent was obtained from each subject. Thirty consecutive patients with asthma (17 men and 13 women; age range, 27-78 years) underwent dynamic oxygen-enhanced MR imaging, multidetector CT, and assessment of forced expiratory volume in 1 second. All patients were classified as having one of four stages of asthma according to the guidelines of the National Asthma Education and Prevention Program. Relative enhancement ratio ( RER relative enhancement ratio ) and wash-in time maps were generated by means of pixel-by-pixel analyses. Regions of interest were placed on images of the lung in all sections, and all measurements were averaged to determine mean RER relative enhancement ratio and mean wash-in time for each subject. Percentage of airway wall area and mean lung density were determined at quantitative CT. For comparison of the modalities for assessment of clinical stage, indexes of subjects at all clinical stages were compared by means of the Tukey honestly significant difference test. Evaluation of pulmonary functional improvement was assessed by correlating improvement of each index with that of forced expiratory volume.
Results:
Mean wash-in time was significantly different among patients with asthma of different clinical stages (P < .05), but significant differences between mean RER relative enhancement ratio and percentage of airway wall area were observed for a limited number of clinical stages (P < .05). Improvement of mean RER relative enhancement ratio (r = 0.63, P = .0002) and mean wash-in time (r = -0.75, P < .0001) was significantly correlated with forced expiratory volume.
Conclusion:
Dynamic oxygen-enhanced MR imaging has potential as a tool for assessment of clinical stage and evaluation of pulmonary functional change due to treatment in patients with asthma.
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