Quantitative multivolume proton-magnetic resonance imaging in patients with cystic fibrosis lung disease: comparison with clinical indicators

Objectives The present cross-sectional study aims to verify the relationship between quantitative multivolume magnetic resonance imaging (MRI) and clinical indicators of ventilatory abnormalities in cystic fibrosis (CF) lung disease. Methods 28 patients (10–27 years) with CF lung disease performed non-enhanced chest MRI, spirometry and multiple breath washout (MBW). Images acquired at end-inspiration and end-expiration were registered by optical flow to estimate expiratory-inspiratory proton density change (Δ 1 H-MRI) as a measure of regional ventilation. MR images were also evaluated using a CF-specific scoring system. Results Biomarkers of CF ventilation impairment were defined from Δ 1 H-MRI: Δ 1 H-MRI median, Δ 1 H-MRI quartile coefficient of variation (QCV) and percent low-ventilation volume (%LVV). Imaging biomarkers correlate to all the clinical measures of ventilation abnormalities, with the strongest correlation between Δ 1 H-MRI median and forced expiratory volume in one second (FEV 1 ) (r 2 =0.44, p 1 H-MRI QCV and lung clearance index (LCI) (r 2 =0.51, p 2 =0.66, p Conclusion The study showed a significant correlation between quantitative multivolume-MRI and clinical indicators of CF lung disease. MRI, as a non-ionizing imaging technique, may be particularly attractive in CF care for longitudinal evaluation, providing a new imaging biomarker to detect early ventilator abnormalities.