Semiautomatic assessment of respiratory dynamics using cine MRI in chronic obstructive pulmonary disease

Hirotaka Sato; Naoko Kawata; Ayako Shimada; Yuma Iwao; Chen Ye; Yoshitada Masuda; Hideaki Haneishi; Koichiro Tatsumi; Takuji Suzuki

doi:10.1016/j.ejro.2022.100442

Semiautomatic assessment of respiratory dynamics using cine MRI in chronic obstructive pulmonary disease

Eur J Radiol Open. 2022 Sep 29:9:100442. doi: 10.1016/j.ejro.2022.100442. eCollection 2022.

Authors

Hirotaka Sato^{1

2}, Naoko Kawata¹, Ayako Shimada³, Yuma Iwao⁴, Chen Ye⁴, Yoshitada Masuda⁵, Hideaki Haneishi⁴, Koichiro Tatsumi¹, Takuji Suzuki¹

Affiliations

¹ Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.
² Department of Radiology, Soka Municipal Hospital, 2-21-1, Souka, Souka-shi, Saitama 340-8560, Japan.
³ Department of Respirology, Shin-yurigaoka General Hospital, 255 Tsuko, Furusawa, Asao, Kawasaki, Kanagawa 215-0026, Japan.
⁴ Center for Frontier Medical Engineering, Chiba University, 1-33, Yayoi-cho, Inage-ku, Chiba 263-8522, Japan.
⁵ Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.

Abstract

Purpose: The quantitative assessment of impaired lung motions and their association with the clinical characteristics of COPD patients is challenging. The aim of this study was to measure respiratory kinetics, including asynchronous movements, and to analyze the relationship between lung area and other clinical parameters.

Materials and methods: This study enrolled 10 normal control participants and 21 COPD patients who underwent dynamic MRI and pulmonary function testing (PFT). The imaging program was implemented using MATLAB®. Each lung area was detected semi-automatically on a coronal image (imaging level at the aortic valve) from the inspiratory phase to the expiratory phase. The Dice index of the manual measurements was calculated, with the relationship between lung area ratio and other clinical parameters, including PFTs then evaluated. The asynchronous movements of the diaphragm were also evaluated using a sagittal image.

Results: The Dice index for the lung region using the manual and semi-automatic extraction methods was high (Dice index = 0.97 ± 0.03). A significant correlation was observed between the time corrected lung area ratio and percentage of forced expiratory volume in 1 s (FEV₁%pred) and residual volume percentage (RV%pred) (r = -0.54, p = 0.01, r = 0.50, p = 0.03, respectively). The correlation coefficient between each point of the diaphragm in the group with visible see-saw like movements was significantly lower than that in the group without see-saw like movements (value = -0.36 vs 0.95, p = 0.001).

Conclusion: Semi-automated extraction of lung area from Cine MRI might be useful for detecting impaired respiratory kinetics in patients with COPD.

Keywords: Asynchronous movement; BMI, body mass index; CAT, chronic obstructive pulmonary disease assessment test; COPD, chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease (COPD); DLCO, carbon monoxide diffusing capacity of the lung; Diaphragm; FEV1, forced expiratory volume in 1 s; FEV1/FVC, forced expiratory volume in 1 s per forced vital capacity; FLASH, fast low angle shot; FOV, field of view; FRC, functional residual capacity; FVC, forced vital capacity; GOLD, Global Initiative for Chronic Pulmonary Obstructive Lung Disease; HASTE, Half Fourier Acquisition Single-shot Turbo spin Echo; ICC, intraclass correlation coefficient; ICS, inhaled corticosteroid; LAA, low attenuation area; LABA, long-acting β-2 agonist; LAMA, long-acting muscarinic antagonists; LAV, low attenuation volume; LV, lung volume; Lung area; MDCT, multi-detector row computed tomography; MRI, magnetic resonance imaging; Magnetic resonance imaging (MRI); PFT, pulmonary function testing; Pulmonary function; RV, residual volume; RV/TLC, residual volume per total lung capacity; SSFP, steady-state free precession; TLA, total lung area; TLC, total lung capacity; UTE, ultrashort echo time.