Pulmonary Imaging of Immunocompromised Patients during Hematopoietic Stem Cell Transplantation using Non-Contrast-Enhanced Three-Dimensional Ultrashort Echo Time (3D-UTE) MRI.
Rofo
; 194(1): 39-48, 2022 01.
Article
em En
| MEDLINE
| ID: mdl-34649285
ABSTRACT
PURPOSE:
To evaluate the feasibility of non-contrast-enhanced three-dimensional ultrashort echo time (3D-UTE) MRI for pulmonary imaging in immunocompromised patients during hematopoietic stem cell transplantation (HSCT).METHODS:
MRI was performed using a stack-of-spirals 3D-UTE sequence (slice thickness 2.34mm; matrix 256â×â256; acquisition time 12.7-17.6 seconds) enabling imaging of the entire thorax within single breath-holds. Patients underwent MRI before HSCT initiation, in the case of periprocedural pneumonia, before discharge, and in the case of re-hospitalization. Two readers separately assessed the images regarding presence of pleural effusions, ground glass opacities (GGO), and consolidations on a per lung basis. A T2-weighted (T2w) multi-shot Turbo Spin Echo sequence (BLADE) was acquired in coronal orientation during breath-hold (slice thickness 6.00mm; matrix 320â×â320; acquisition time 3.1-5.5âmin) and read on a per lesion basis. Low-dose CT scans in inspiration were used as reference and were read on a per lung basis. Only scans performed within a maximum of three days were included in the inter-method analyses. Interrater agreement, sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of 3D-UTE MRI were calculated.RESULTS:
67 MRI scans of 28 patients were acquired. A reference CT examination was available for 33 scans of 23 patients. 3D-UTE MRI showed high sensitivity and specificity regarding pleural effusions (nâ=â6; sensitivity, 92â%; specificity, 100â%) and consolidations (nâ=â22; sensitivity 98â%, specificity, 86â%). Diagnostic performance was lower for GGO (nâ=â9; sensitivity, 63â%; specificity, 84â%). Accuracy rates were high (pleural effusions, 98â%; GGO, 79â%; consolidations 94â%). Interrater agreement was substantial for consolidations and pleural effusions (κâ=â0.69-0.82) and moderate for GGO (κâ=â0.54). Compared to T2w imaging, 3D-UTE MRI depicted the assessed pathologies with at least equivalent quality and was rated superior regarding consolidations and GGO in ~50â%.CONCLUSION:
Non-contrast 3D-UTE MRI enables radiation-free assessment of typical pulmonary complications during HSCT procedure within a single breath-hold. Yet, CT was found to be superior regarding the identification of pure GGO changes. KEY POINTS · 3D-UTE MRI of the thorax can be acquired within a single breath-hold.. · 3D-UTE MRI provides diagnostic imaging of pulmonary consolidations and pleural effusions.. · 3D-UTE sequences improve detection rates of ground glass opacities on pulmonary MRI.. · 3D-UTE MRI depicts pulmonary pathologies at least equivalent to T2-weighted Blade sequence.. CITATION FORMAT · Metz C, Böckle D, Heidenreich JF etâal. Pulmonary Imaging of Immunocompromised Patients during Hematopoietic Stem Cell Transplantation using Non-Contrast-Enhanced Three-Dimensional Ultrashort Echo Time (3D-UTE) MRI. Fortschr Röntgenstr 2022; 194 39â-â48.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Células-Tronco Hematopoéticas
/
Imageamento Tridimensional
Limite:
Humans
Idioma:
En
Revista:
Rofo
Ano de publicação:
2022
Tipo de documento:
Article