Contemporary 0.55 T MRI to visualize interstitial lung disease - An exploratory study

Area of Science:

• Radiology
• Pulmonary Medicine
• Medical Imaging

Background:

• Interstitial lung disease (ILD) diagnosis and monitoring often rely on high-resolution computed tomography (HRCT).
• HRCT involves ionizing radiation, prompting the search for alternative imaging modalities.
• Low-field magnetic resonance imaging (MRI) offers a radiation-free approach to visualize lung structures.

Purpose of the Study:

• To assess the feasibility of contemporary 0.55 Tesla (T) MRI for visualizing interstitial lung disease (ILD).
• To compare the diagnostic performance of 0.55T MRI against high-resolution computed tomography (HRCT) in patients with rheumatologic ILD.
• To evaluate MRI's ability to quantify overall disease extent, ground-glass opacity (GGO), and reticulation.

Main Methods:

• Thirty participants with rheumatologic ILD underwent both HRCT and 0.55T MRI within 31 days.
• MRI protocols included proton-density-weighted and T2-weighted sequences.
• Three blinded radiologists independently assessed disease features using semi-quantitative scoring, with data analyzed via Wilcoxon signed-rank and Bland-Altman tests.

Main Results:

• No statistically significant difference was found in the overall extent of ILD between 0.55T MRI and HRCT (22.5% vs. 24.5%).
• MRI significantly overestimated ground-glass opacity (GGO) (13.1% vs. 9.7%) and underestimated reticulation (8.1% vs. 11.4%) compared to HRCT.
• Excellent interobserver agreement was observed for both modalities (MRI ICC = 0.94; HRCT ICC = 0.97).

Conclusions:

• Contemporary 0.55T MRI is feasible for assessing overall ILD extent, showing no significant difference compared to HRCT.
• Despite limitations in quantifying GGO and reticulation, 0.55T MRI shows potential as a radiation-free tool for gross ILD burden assessment.
• Further technical advancements are warranted before 0.55T MRI can be routinely implemented in clinical practice for ILD evaluation.