Free-breathing dynamic contrast-enhanced magnetic resonance of interstitial lung fibrosis

Computed tomography (CT) imaging is the standard to assess interstitial lung disease. Magnetic resonance (MR) is potentially advantageous due to superior tissue characterization and better assessment of blood flow dynamics. This study aimed to evaluate idiopathic pulmonary fibrosis (IPF) using prototype 4D Stack of Stars GRE (StarVIBE) MR and compare it to CT.

This IRB-approved prospective study included 13 patients [5F:8M; average age 66 ± 8.1 years] with pulmonary fibrosis, and 12 healthy controls [3F:9M; average age 55 ± 3.6 years]. MR of the chest included noncontrast steady-state free precession imaging (SSFP) and free-breathing 4D StarVIBE sequence with intravenous contrast administration up to 160 s. The images were assessed for quality and artifacts. The image resolution was evaluated based on the visibility of the smallest bronchi, vessels, lymph nodes, and pleural fissures. Independent assessment of reticulation, ground-glass opacity, and traction bronchiectasis was performed and compared to CT.

The StarVIBE images had fewer artifacts and higher spatial resolution. The findings associated with IPF were significantly better seen with StarVIBE, with superior CT correlation.

Contrast-enhanced free-breathing StarVIBE MR can generate high quality images with good correlation to CT in patients with IPF, and with high spatial and temporal resolution to generate rapid sequential dynamic images.