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Ventilation and Perfusion Defects on Phase-Resolved Functional Lung (PREFUL) MRI Predict Silicosis Progression: A
Tao Ouyang1,2,3,4, Yiran Wang5, Hongmei Zhang2,3,4
1Department of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Journal of Magnetic Resonance Imaging : JMRI
|November 24, 2025
Summary
Phase-resolved functional lung (PREFUL) MRI can predict silicosis progression. Increased ventilation and perfusion defects identified by PREFUL MRI are associated with disease worsening, aiding early risk identification.
Area of Science:
- Radiology
- Pulmonary Medicine
- Occupational Health
Background:
- Silicosis is an irreversible occupational lung disease causing inflammation and fibrosis.
- Early identification of individuals at high risk for silicosis progression is crucial.
- Current biomarkers for predicting silicosis progression are lacking.
Purpose of the Study:
- To assess the predictive capability of ventilation and perfusion defects quantified by phase-resolved functional lung (PREFUL) MRI for silicosis progression.
- To determine if PREFUL MRI metrics can identify individuals with silicosis who are likely to progress.
Main Methods:
- A prospective study involving 30 participants with silicosis and 30 healthy controls.
- Quantitative analysis of ventilation defect percentages (VDP) and perfusion defect percentage (QDP) using PREFUL MRI.
- Follow-up for 1 year assessing pulmonary function tests (PFTs), symptoms, and chest CT for disease progression.
Main Results:
- Eight silicosis patients progressed, while 22 remained stable over 1 year.
- Significantly higher baseline VDP and QDP were observed in progressors compared to non-progressors.
- QDP demonstrated strong predictive performance for radiological progression (AUC=0.72), PFT decline (AUC=0.90), and global progression (AUC=0.97).
Conclusions:
- Elevated ventilation and perfusion defects detected by PREFUL MRI are significantly associated with silicosis progression.
- PREFUL MRI shows potential as a non-invasive tool for predicting silicosis progression.
- These findings highlight the utility of PREFUL MRI in managing silicosis patients.
