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Validating chest MRI to detect and monitor cystic fibrosis lung disease in a pediatric cohort
Author(s) -
Tepper Leonie A.,
Ciet Pierluigi,
Caudri Daan,
Quittner Alexandra L.,
Utens Elisabeth M.W.J.,
Tiddens Harm A.W.M.
Publication year - 2016
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23328
Subject(s) - bronchiectasis , medicine , magnetic resonance imaging , cystic fibrosis , radiology , cohort , nuclear medicine , lung
Summary Background Computed Tomography (CT) is the gold standard to assess bronchiectasis and trapped air in cystic fibrosis (CF) lung disease, but has the disadvantage of radiation exposure. Magnetic Resonance Imaging (MRI) is a radiation free alternative. Objective To validate MRI as outcome measure by: correlating MRI scores for bronchiectasis and trapped air with clinical parameters, and by comparing those MRI scores with CT scores. Methods In patients with CF (aged 5.6–17.4 years), MRI and CT were alternated annually during routine annual check‐ups between July 2007 and January 2010. Twenty‐three children had an MRI performed 1 year prior to CT, 34 children had a CT 1 year prior to MRI. Bronchiectasis and trapped air were scored using the CF‐MRI and CF‐CT scoring system. CF‐MRI scores were correlated with clinical parameters: FEV 1 , Pseudomonas aeruginosa , pulmonary exacerbations and patient‐reported respiratory symptoms measured on the Cystic Fibrosis Questionnaire‐Revised (CFQ‐R), using Spearman's correlation coefficient. MRI and CT scores were compared using intra‐class correlation coefficients (ICC) and Bland–Altman plots. Results Fifty‐seven patients who had an MRI, CT and CFQ‐R during the study period were included. CF‐MRI bronchiectasis correlated with FEV 1 , Pseudomonas aeruginosa , pulmonary exacerbations and patient‐reported respiratory symptoms. CF‐MRI trapped air only correlated with FEV 1 and Pseudomonas aeruginosa . ICCs between MRI and CT bronchiectasis and trapped air were 0.41 and 0.35 respectively. MRI tended to overestimate bronchiectasis compared to CT. Conclusion The associations between CF‐MRI scores and several important clinical parameters further contributes to the validation of MRI. MRI provides different information than CT. Pediatr Pulmonol. 2016;51:34–41. © 2015 Wiley Periodicals, Inc.