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Comparison of phase-resolved functional lung (PREFUL) MRI and CT parametric response mapping (PRM) in COSYCONET COPD
Andreas Voskrebenzev1,2,3, Marcel Gutberlet4,5, Filip Klimeš4,5,6
1Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany. voskrebenzev.andreas@mh-hannover.de.
European Radiology
|March 28, 2026
Summary
Phase-resolved functional lung (PREFUL) MRI effectively quantifies regional ventilation in chronic obstructive pulmonary disease (COPD). This non-invasive imaging correlates well with CT-based parametric response mapping (PRM) for disease assessment.
Area of Science:
- Pulmonary Medicine and Imaging
- Radiology and Medical Imaging
- Cardiovascular and Respiratory Systems
Background:
- Chronic obstructive pulmonary disease (COPD) significantly impacts lung function and requires accurate methods for assessing regional ventilation.
- Current methods for evaluating ventilation in COPD often involve radiation exposure or are less precise in regional assessment.
- Non-contrast enhanced magnetic resonance imaging (MRI) offers a potential radiation-free alternative for lung imaging.
Purpose of the Study:
- To compare regional ventilation measured by ventilation-weighted phase-resolved functional lung (PREFUL) MRI with parametric response mapping (PRM) derived from CT scans.
- To assess the correlation between PREFUL MRI ventilation defect percentage (PREFUL-VDP) and pulmonary function test (PFT) parameters in COPD patients.
- To evaluate PREFUL MRI as a non-invasive, radiation-free tool for quantifying regional ventilation in COPD.
Main Methods:
- Retrospective analysis of a single-center subset of the prospective COSYCONET COPD cohort.
- PREFUL MRI was performed during free breathing at 1.5T. Parametric response mapping (PRM) was derived from paired inspiratory and expiratory low-dose CT scans.
- Co-registration of matched coronal slices of PREFUL and PRM. Calculation of PREFUL-VDP, PRM functional small airway disease (PRMfSAD), emphysema (PRMemph), and combined metric (PRMfSAD+emph). Statistical analysis included Spearman's correlation and spatial overlap metrics.
Main Results:
- PREFUL-VDP showed strong correlation with the combined PRM metric (PREFUL-VDP vs PRMfSAD+emph, r=0.86, p<0.001) and with PFT parameters (PREFUL-VDP vs FEV1, r=-0.75, p<0.001).
- Correlations between PREFUL-VDP and individual PRM metrics (PRMfSAD, PRMemph) were weaker (r=0.57 and r=0.82, respectively, p<0.001).
- Highest spatial congruence was observed between PREFUL-VDP and PRMfSAD+emph, indicating PREFUL-VDP quantifies overall ventilation impairment without distinguishing between small airway disease and emphysema.
Conclusions:
- PREFUL-VDP demonstrates a strong correlation with the combined CT-based PRM metric for emphysema and functional small airways disease in COPD patients.
- PREFUL MRI is a promising non-invasive, radiation-free tool for quantifying regional ventilation in COPD, offering valuable insights into disease characterization.
- While PREFUL MRI does not differentiate between emphysema and small airway disease, its strong correlation with PRM highlights its utility for functional monitoring in COPD.
