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This cross-sectional study aims to verify the relationship between quantitative multivolume proton-magnetic resonance imaging ( 1 H-MRI) and clinical indicators of ventilatory abnormalities in cystic fibrosis (CF) lung disease.  Non-enhanced chest MRI, spirometry and multiple breath washout was performed by 28 patients (10–27 years) with CF lung disease. 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. Magnetic resonance images were also evaluated using a CF-specific scoring system.  Biomarkers of CF ventilation impairment were defined from the Δ 1 H-MRI as follows: Δ 1 H-MRI median, Δ 1 H-MRI quartile coefficient of variation (QCV) and percentage of low-ventilation volume (%LVV). Imaging biomarkers correlated to all the clinical measures of ventilation abnormality, with the strongest correlation between Δ 1 H-MRI median and forced expiratory volume in 1 s (r 2 =0.44, p&lt;0.001), Δ 1 H-MRI QCV and lung clearance index (LCI) (r 2 =0.51, p&lt;0.001) and %LVV and LCI (r 2 =0.66, p&lt;0.001). Correlations were also found between imaging biomarkers of ventilation and morphological scoring.  The study showed a significant correlation between quantitative multivolume MRI and clinical indicators of CF lung disease. MRI, as a non-ionising imaging technique, may be particularly attractive in CF care for longitudinal evaluation, providing a new imaging biomarker to detect early ventilatory abnormalities.

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