Respiratory motion-resolved four-dimensional zero echo time (4D ZTE) lung MRI using retrospective soft gating:...

To evaluate the feasibility and image quality of respiratory motion-resolved 4D zero echo time (ZTE) lung MRI compared with that of 3D ZTE.

Our institutional review board approved this study. Twenty-one patients underwent lung scans using 3D ZTE and 4D ZTE sequences via prospective and retrospective soft gating techniques, respectively. Image qualities of 3D ZTE and 4D ZTE at end-expiration were compared through objective and subjective assessments. The quality of end-expiratory images of 3D ZTE and 4D ZTE of the two groups with different lung functions was also compared.

Images were successfully acquired in all patients without any adverse events. Signal-to-noise ratios (SNRs) of lung parenchyma and thoracic structures were significantly (all p < 0.001) higher in 4D ZTE. Contrast-to-noise ratios (CNRs) of peripheral bronchi, peripheral pulmonary vessels, and nodules or masses were significantly (all p < 0.001) higher in 4D ZTE. The subjective image quality assessed by two independent radiologists showed that intrapulmonary structures, noise and artifacts, and overall acceptability were superior in 4D ZTE (all p < 0.001). Image qualities of groups with normal and low lung functions differed significantly (all p < 0.05) in 3D ZTE, but not in 4D ZTE. The mean acquisition time was 136 s (127-143 s) in 3D ZTE and 325 s (308-352 s) in 4D ZTE.

Respiratory motion-resolved 4D ZTE lung imaging was feasible as part of routine chest MRI. The 4D ZTE provides motion-robust lung parenchymal images with better SNR and CNR than the 3D ZTE, regardless of patients' lung function.

• ZTE MRI captures rapidly decaying transverse magnetization in the lung parenchyma. • 4D ZTE provides motion-robust lung parenchymal images with better SNR and CNR compared with 3D ZTE. • Compared with 3D ZTE, the image quality of 4D ZTE lung MRI was affected less by patients' lung function and respiratory performance.