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Region of interest-based versus whole-lung segmentation-based approach for MR lung perfusion quantification in
M Weis1, V Sommer2, F G Zöllner3
1Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer Ufer 1-3, 68167, Mannheim, Germany. Meike.Weis@medma.uni-heidelberg.de.
Insights
MR lung perfusion imaging in children with congenital diaphragmatic hernia (CDH) shows reduced blood flow ipsilaterally. Whole-lung analysis is preferred over region-of-interest methods, which overestimate contralateral lung perfusion.
Area of Science:
- Medical imaging
- Pediatric radiology
- Pulmonary medicine
Background:
- Congenital diaphragmatic hernia (CDH) can lead to long-term pulmonary complications.
- Assessing lung perfusion is crucial for evaluating outcomes after CDH repair.
- Previous studies utilized region-of-interest (ROI) based approaches for MR lung perfusion.
Purpose of the Study:
- To evaluate the reproducibility of MR lung perfusion measurements using whole-lung segmentation compared to ROI-based methods in children post-CDH.
- To identify differences in perfusion quantification between ROI-based and whole-lung segmentation approaches.
- To determine the optimal method for assessing MR lung perfusion in pediatric CDH patients.
Main Methods:
- Dynamic contrast-enhanced (DCE) MRI was used to quantify pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT).
- Pulmonary perfusion was assessed in 30 children after CDH repair using both ROI-based and whole-lung segmentation methods.
- Quantification results from the two segmentation approaches were statistically compared.
Main Results:
- Both ROI-based and whole-lung segmentation showed significantly reduced PBF and PBV in the ipsilateral lungs (p < 0.0001).
- Ipsilateral PBF measurements were comparable between ROI-based and whole-lung approaches (p=0.50).
- The ROI-based approach significantly overestimated contralateral PBF by approximately 9.5% compared to whole-lung segmentation (p=0.0013).
Conclusions:
- MR lung perfusion is significantly reduced in the ipsilateral lung of children after CDH.
- Whole-lung segmentation is recommended for accurate MR lung perfusion assessment, as ROI-based methods overestimate perfusion in the contralateral lung.
- MR lung perfusion offers a radiation-free method for evaluating lung function in pediatric CDH patients.
Objective:
With a region of interest (ROI)-based approach 2-year-old children after congenital diaphragmatic hernia (CDH) show reduced MR lung perfusion values on the ipsilateral side compared to the contralateral. This study evaluates whether results can be reproduced by segmentation of whole-lung and whether there are differences between the ROI-based and whole-lung measurements.
Methods:
Using dynamic contrast-enhanced (DCE) MRI, pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) were quantified in 30 children after CDH repair. Quantification results of an ROI-based (six cylindrical ROIs generated of five adjacent slices per lung-side) and a whole-lung segmentation approach were compared.
Results:
In both approaches PBF and PBV were significantly reduced on the ipsilateral side (p always <0.0001). In ipsilateral lungs, PBF of the ROI-based and the whole-lung segmentation-based approach was equal (p=0.50). In contralateral lungs, the ROI-based approach significantly overestimated PBF in comparison to the whole-lung segmentation approach by approximately 9.5 % (p=0.0013).
Conclusions:
MR lung perfusion in 2-year-old children after CDH is significantly reduced ipsilaterally. In the contralateral lung, the ROI-based approach significantly overestimates perfusion, which can be explained by exclusion of the most ventral parts of the lung. Therefore whole-lung segmentation should be preferred.
Key Points:
• Ipsilaterally, absolute lung perfusion after CDH is reduced in whole-lung analysis. • Ipsilaterally, the ROI- and whole-lung-based approaches generate identical results. • Contralaterally, the ROI-based approach significantly overestimates perfusion results. • Whole lung should be analysed in MR lung perfusion imaging. • MR lung perfusion measurement is a radiation-free parameter of lung function.
