Details

Autor(en) / Beteiligte

• Ebner, Lukas
• Virgincar, Rohan S
• He, Mu
• Choudhury, Kingshuk R
• Robertson, Scott H
• Christe, Andreas
• Mileto, Achille
• Mammarapallil, Joseph G
• McAdams, H Page
• Driehuys, Bastiaan
• Roos, Justus E

Titel

Multireader Determination of Clinically Significant Obstruction Using Hyperpolarized 129 Xe-Ventilation MRI

Ist Teil von

• American journal of roentgenology (1976), 2019-04, Vol.212 (4), p.758-765

Ort / Verlag

United States

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• The objective of our study was to identify the magnitude and distribution of ventilation defect scores (VDSs) derived from hyperpolarized (HP) Xe-MRI associated with clinically relevant airway obstruction. From 2012 to 2015, 76 subjects underwent HP Xe-MRI (48 healthy volunteers [mean age ± SD, 54 ± 17 years]; 20 patients with asthma [mean age, 44 ± 20 years]; eight patients with chronic obstructive pulmonary disease [mean age, 67 ± 5 years]). All subjects underwent spirometry 1 day before MRI to establish the presence of airway obstruction (forced expiratory volume in 1 second-to-forced vital capacity ratio [FEV /FVC] < 70%). Five blinded readers assessed the degree of ventilation impairment and assigned a VDS (range, 0-100%). Interreader agreement was assessed using the Fleiss kappa statistic. Using FEV /FVC as the reference standard, the optimum VDS threshold for the detection of airway obstruction was estimated using ROC curve analysis with 10-fold cross-validation. Compared with the VDSs in healthy subjects, VDSs in patients with airway obstruction were significantly higher (p < 0.0001) and significantly correlated with disease severity (r = 0.66, p < 0.0001). Ventilation defects in subjects with airway obstruction did not show a location-specific pattern (p = 0.158); however, defects in healthy control subjects were more prevalent in the upper lungs (p = 0.014). ROC curve analysis yielded an optimal threshold of 12.4% ± 6.1% (mean ± SD) for clinically significant VDS. Interreader agreement for Xe-MRI was substantial (κ = 0.71). This multireader study of a diverse cohort of patients and control subjects suggests a Xe-ventilation MRI VDS of 12.4% or greater represents clinically significant obstruction.