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Oxygen-enhanced Magnetic Resonance Imaging versus Computed Tomography

Multicenter Study for Clinical Stage Classification of Smoking-related Chronic Obstructive Pulmonary Disease

¹ Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan; ² Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan; ³ Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; ⁴ Pulmonary Division, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan; ⁵ Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea; and ⁶ Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

Correspondence and requests for reprints should be addressed to Yoshiharu Ohno, M.D., Ph.D., Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan. E-mail: yosirad{at}kobe-u.ac.jp

Rationale: Oxygen-enhanced magnetic resonance imaging (MRI) has been proposed as a useful tool for assessing regional morphological and functional changes in chronic obstructive pulmonary disease (COPD).

Objectives: To prospectively and directly compare the efficacy of O₂-enhanced MRI and quantitative computed tomography (CT) for smoking-related pulmonary functional loss assessment and clinical stage classification of smoking-related COPD.

Methods: One hundred sixty smokers were classified into four age- and gender-matched groups by using the GOLD criteria for smokers: Smokers without COPD (n = 40), Mild COPD (n = 40), Moderate COPD (n = 40), and Severe or Very Severe COPD (n = 40). All smokers underwent O₂-enhanced MRI, multidetector-row CT, and pulmonary function test. Mean relative enhancement ratio on O₂-enhanced MRI and CT-based functional lung volume (FLV) on quantitative CT were calculated. To compare the efficacy of O₂-enhanced MRI and quantitative CT for pulmonary functional loss assessment, both indexes were correlated with pulmonary functional parameters. To determine the efficacy of two methods for clinical stage classification, the four clinical groups' mean relative enhancement ratio and CT-based FLV were statistically compared.

Measurements and Main Results: Correlations of both indexes with pulmonary functional parameters were significant (P < 0.0001). Pulmonary functional parameters and mean relative enhancement ratio for the four clinical groups showed significant differences (P < 0.05). CT-based FLVs of smokers without COPD and mild COPD were significantly different from those for moderate COPD and severe or very severe COPD (P < 0.05).

Conclusions: O₂-enhanced MRI is effective for pulmonary functional loss assessment and clinical stage classification of smoking-related COPD and quantitative CT.

Key Words: lung • magnetic resonance • oxygen • lung ventilation • diffusing capacity

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Oxygen-enhanced magnetic resonance imaging (MRI) has been proposed as a useful tool for assessing regional morphological and functional changes in chronic obstructive pulmonary disease (COPD) but there is limited information comparing oxygen-enhanced MRI and quantitative computed tomography (CT). What This Study Adds to the Field Oxygen-enhanced MRI has the potential for pulmonary functional loss assessment and clinical stage classification in smoking-related COPD. It can evaluate COPD as well as pulmonary function testing and quantitatively assessed thin-section CT.